Spinal cord injury (SCI) often leads to motor and sensory deficits, in addition to other complications, such as autonomic dysfunction, respiratory problems and urinary incontinence. These limitations seem to be be preventing the translation into clinical practice of these technological devices created in the laboratory. Technical improvements in aspects such as the user intent detection, portability or calibration as well as consistent assessment of functional outcomes were the main identified limitations. SR and FES wearable devices are promising technologies to support hand function recovery in subjects with SCI. A wide range of functional assessment tests were adopted, moreover, most studies used non-standardized tests. From the clinician point of view, the most suitable technical features (e.g., user intent detection) and assessment tools should be determined according to the particular patient condition. From an engineering perspective, technological improvements for home-based use such as portability, donning/doffing and the time spent with calibration were identified. Most studies were limited to research prototypes, designed either for assistance or therapy. ResultsĪ total of 37 out of 1101 articles were selected, 12 regarding SR and 25 involving FES devices. The final collections of both groups (SR and FES) were analysed based on the technical aspects and reported functional outcomes. Only studies that reported functional outcomes from individuals with SCI were selected. MethodsĪ literature search was performed in Scopus, Pubmed and IEEE Xplore for articles involving SR devices or FES systems designed for hand therapy or assistance, published since 2010. This narrative review aims at providing a guide both for engineers to help in the development of new technologies and for clinicians to serve as clinical guidelines based on the available technology in order to assist and/or recover hand function in people with SCI. However, the implementation of these wearable devices has not been compiled in a review focusing on the functional outcomes they can activate/elicit/stimulate/potentiate. Wearable devices based on soft robotics (SR) or functional electrical stimulation (FES) have been employed to assist the recovery of hand function both during activities of daily living (ADLs) and during therapy. Recovery of hand function is crucial for the independence of people with spinal cord injury (SCI).
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