Francesca Gimigliano1, Angela Palomba2, Chiara Arienti3, Giovanni Morone4, Luca Perrero5, Michela Agostini6, Irene Aprile7, Matteo Paci8, Emanuela Casanova9, Dario Marino10, Giuseppe LA Rosa11, Federica Bressi12, Silvia Sterzi12, Daniele Giansanti13, Alberto Battistini8, Sandra Miccinilli12, Serena Filoni14, Monica Sicari15, Salvatore Petrozzino15, Claudio M Solaro16, Stefano Gargano17, Paolo Benanti18, Paolo Boldrini19, Donatella Bonaiuti20, Enrico Castelli21, Francesco Draicchio22, Vincenzo Falabella23, Silvia Galeri3, Mauro Grigioni13, Stefano Mazzoleni24, Stefano Mazzon25, Franco Molteni26, Maurizio Petrarca27, Alessandro Picelli28, Federico Posteraro29, Michele Senatore30, Giuseppe Turchetti31, Sofia Straudi32. 1. Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy. 2. Multidisciplinary Department of Medicine for Surgery and Orthodontics, University of Campania "Luigi Vanvitelli", Naples, Italy - angela.palomba@unicampania.it. 3. IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy. 4. Santa Lucia Foundation, IRCCS, Rome, Italy. 5. Neurorehabilitation Unit, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy. 6. San Camillo IRCCS, Venice, Italy. 7. IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy. 8. AUSL (Unique Sanitary Local Company) District of Central Tuscany, Florence, Italy. 9. IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Medicina Riabilitativa e Neuroriabilitazione, Bologna, Italia. 10. IRCCS Neurolysis Center "Bonino Pulejo", Messina, Italy. 11. C.S.R. - Consorzio Siciliano di Riabilitazione, Catania, Italy. 12. Campus Bio-Medico University Hospital, Rome, Italy. 13. National Center for Innovative Technologies in Public Health, Italian National Institute of Health, Rome, Italy. 14. Padre Pio Foundation and Rehabilitation Centers, San Giovanni Rotondo, Foggia, Italy. 15. A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy. 16. CRRF "Mons. Luigi Novarese" Moncrivello, Vercelli, Italy. 17. Fondazione Don Carlo Gnocchi, Turin, Italy. 18. Pontifical Gregorian University, Rome, Italy. 19. Società Italiana di Medicina Fisica e Riabilitativa (SIMFER). 20. Istituto Geriatrico Piero Redaelli, Milan, Italy. 21. Paediatric Neurorehabilitation, Bambino Gesù Children's Hospital, Rome, Italy. 22. Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Monte Porzio Catone, Rome, Italy. 23. President Italian Federation of Persons with Spinal Cord Injuries (Faip Onlus), Rome, Italy. 24. Department of Electrical and Information Engineering, Politecnico di Bari, Bari, Italy. 25. Rehabilitation Department, AULSS6 (Unique Sanitary Local Company) Euganea Padova, Padova, Italy. 26. Villa Beretta, Costa Masnaga, Lecco, Italy. 27. "Bambino Gesù" Children's Hospital - IRCCS, Movement Analysis and Robotics Laboratory MARlab, Rome, Italy. 28. Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy. 29. Versilia Hospital AUSL Toscana Nord Ovest, Lido di Camaiore, Lucca, Italy. 30. Presidente AITO (Associazione Italiana Terapisti Occupazionali). 31. Management Institute, Sant'Anna School of Advanced Studies, Pisa, Italy. 32. Neuroscience and Rehabilitation Department, Ferrara University Hospital, Ferrara, Italy.
Abstract
BACKGROUND: Robot-assisted Arm Therapy (RAT) has been increasingly applied in the last years for promoting functional recovery in patients with disabilities related to neurological health conditions. Evidence of a knowledge-to-action gap for applying robot-assisted technologies in the rehabilitation of patients with neurological health conditions and the difficulty to apply and tailor the knowledge to the local contexts solicited the need for a national consensus conference on these interventions. AIM: This paper aims to explain the methodology used by the working group dedicated to synthesize evidence on the effectiveness of RAT in neurological health conditions in the context of the CICERONE Italian Consensus Conference. DESIGN: The methodological approach of the working group. SETTING: All rehabilitation settings. POPULATION: Patients with disability following a neurological health condition. METHODS: Following the indications proposed by the Methodological Manual published by the Italian National Institute of Health, a Promoting Committee and a Technical Scientific Committee have been set up. Six working groups (WGs) have been composed to collect evidence on different questions, among which WG2.2 was focused on the effectiveness of RAT in neurological health conditions. RESULTS: WG2.2 started its work defining the specific research questions. It was decided to adopt the ICF as the reference framework for the reporting of all outcomes. Literature search, data extraction and qualitative assessment, evidence analysis and synthesis have been performed. CONCLUSIONS: This paper summarizes the methodological approaches used by the WG2.2 of the CICERONE Italian Consensus Conference to define the effectiveness of RAT in the management of patients with neurological health conditions. CLINICAL REHABILITATION IMPACT: WG2.2 synthesis might help clinicians, researchers, and all rehabilitation stakeholders to address the use of RAT in the Individualized Rehabilitation Plan, to guide the allocation of resources and define clinical protocols and indications for the management of patients with different neurological health conditions.
BACKGROUND: Robot-assisted Arm Therapy (RAT) has been increasingly applied in the last years for promoting functional recovery in patients with disabilities related to neurological health conditions. Evidence of a knowledge-to-action gap for applying robot-assisted technologies in the rehabilitation of patients with neurological health conditions and the difficulty to apply and tailor the knowledge to the local contexts solicited the need for a national consensus conference on these interventions. AIM: This paper aims to explain the methodology used by the working group dedicated to synthesize evidence on the effectiveness of RAT in neurological health conditions in the context of the CICERONE Italian Consensus Conference. DESIGN: The methodological approach of the working group. SETTING: All rehabilitation settings. POPULATION: Patients with disability following a neurological health condition. METHODS: Following the indications proposed by the Methodological Manual published by the Italian National Institute of Health, a Promoting Committee and a Technical Scientific Committee have been set up. Six working groups (WGs) have been composed to collect evidence on different questions, among which WG2.2 was focused on the effectiveness of RAT in neurological health conditions. RESULTS: WG2.2 started its work defining the specific research questions. It was decided to adopt the ICF as the reference framework for the reporting of all outcomes. Literature search, data extraction and qualitative assessment, evidence analysis and synthesis have been performed. CONCLUSIONS: This paper summarizes the methodological approaches used by the WG2.2 of the CICERONE Italian Consensus Conference to define the effectiveness of RAT in the management of patients with neurological health conditions. CLINICAL REHABILITATION IMPACT: WG2.2 synthesis might help clinicians, researchers, and all rehabilitation stakeholders to address the use of RAT in the Individualized Rehabilitation Plan, to guide the allocation of resources and define clinical protocols and indications for the management of patients with different neurological health conditions.