دانلود رایگان مقاله انگلیسی تاثیر رباتیک ها و واقعیت مجازی بر پیشرفت واقعی توانبخشی آینه درمانی - هینداوی 2018

Background

Mirror therapy has been used in rehabilitation for multiple indications since the 1990s. Current evidence supports some of these indications, particularly for cerebrovascular accidents in adults and cerebral palsy in children. Since 2000s, computerized or robotic mirror therapy has been developed and marketed. Objectives. To map the extent, nature, and rationale of research activity in robotic or computerized mirror therapy and the type of evidence available for any indication. To investigate the relevance of conducting a systematic review and meta-analysis on these therapies. Method. Systematic scoping review. Searches were conducted (up to May 2018) in the Cochrane Library, Google Scholar, IEEE Xplore, Medline, Physiotherapy Evidence Database, and PsycINFO databases. References from identifed studies were examined. Results. In sum, 75 articles met the inclusion criteria. Most studies were publicly funded (57% of studies; n = 43), without disclosure of confict of interest (59% of studies; n = 44). Te main outcomes assessed were pain, satisfaction on the device, and body function and activity, mainly for stroke and amputees patients and healthy participants. Most design studies were case reports (67% of studies; n = 50), with only 12 randomized controlled trials with 5 comparing standard mirror therapy versus virtual mirror therapy, 5 comparing second-generation mirror therapy versus conventional rehabilitation, and 2 comparing other interventions. Conclusion. Much of the research on second-generation mirror therapy is of very low quality. Evidence-based rationale to conduct such studies is missing. It is not relevant to recommend investment by rehabilitation professionals and institutions in such devices.

Discussion

Summary of Findings.

We have mapped the extent, nature, and rationale of research activity in robotic or computerized mirror therapy. Te main sources and types of evidence available about the efectiveness of these therapies for any indication are case series or reports. Only fve RCTs on conventional versus second-generation mirror therapy exist, and fve on second-generation mirror therapy versus conventional rehabilitation. Owing to the heterogeneity of included studies, a meta-analysis was not considered to be appropriate. Tere is either an absence of a rationale, or a nonevidence-based rationale to justify the conduct of studies on the efcacy of second-generation mirror therapy, despite public funding. Disclosure of confict of interest was missing for a majority of the included studies.

Strengths and Weaknesses of the Review.

Te major strength of this review is the extensive search in 6 electronic databases, especially in the search engine of the world’s largest technical professional organization dedicated to advancing technology (IEEE Xplore). Moreover, the inclusion criteria were broad: seven languages were accepted, as well as any type of design. A potential limitation is that the search was conducted only in English or French in the electronic databases. However, about 1/3 of the studies included come from the Asian continent. Scientifc document in Asian language (and particularly Chinese) being prevalent [92], it is possible that there are other studies of better quality in Asian language. However, we systematically reviewed the references lists of included studies, and we have not identifed bibliographic references in Asian language in articles by Asian authors. Te large number of diferent types of device name (see Table S3 in Supplementary Materials) probably explains the high number of studies included thanks to the complementary search. Te main search did not take into account all the keywords, but this scoping review allowed identifying these keywords in a more exhaustive way.