Usability of mechanical assistive technologies for performing activities involving the upper extremities in individuals with impairments: a systematic review

Abstract

Purpose

To conduct a systematic review on the impacts of using mechanical assistive devices on function, performance in activities and participation of persons with upper extremity impairments, and to synthesize the strengths and limitations of these devices.

Method

Three independent reviewers conducted systematic searches of articles published between 2003 and 2023 in Compendex, Inspec, Embase, PubMed/Medline, IEEE Xplore, and Web of Science, as well as manual searches on the RESNA website for conference papers over the same period. The methodological quality of articles was appraised using the QualSyst tool.

Results

From the 34 retained studies, 28 mechanical devices were identified and classified into two categories: (1) mobile arm supports (MASs) designed to perform multiple activities, and (2) devices used to assist with a specific activity of daily living (ADL). Overall, MASs helped users to perform manual activities in elevation and/or against gravity. Specific ADL devices allowed users to perform unique activities requiring fine motor skills such as opening a medicine container. Some of these devices have advantages like portability, adaptability, low cost, and ease of use. Limitations most often reported included interference or mobility restraints.

Conclusion

This review synthesizes the impacts of mechanical devices on the three domains of the International Classification of Functioning, Disability and Health (ICF) for individuals with upper extremity impairments. Impacts regarding function and performance in activities were more often measured than participation. Future studies should include outcomes related to participation, as taking this aspect into account might favor successful continued use of assistive devices.

IMPLICATIONS FOR REHABILITATION

1. Mechanical mobile arm supports can compensate for upper extremity muscle weakness and help users to perform diverse activities against gravity, including self-care, productivity and leisure activities.

2. Mechanical assistive devices designed for specific activities of daily living (ADLs) can increase users’ ability to perform activities requiring manual dexterity and fine motor skills, such as eating, handwriting, performing personal care or playing a musical instrument.

3. Portability, adaptability, low cost, and ease of use are most often reported as strengths of specific ADL devices, while interference and mobility restrictions are aspects that still need to be reduced with respect to mechanical mobile arm supports.

Keywords:

• Mechanical assistive devices
• activities of daily living
• impairments
• upper extremities
• systematic review
• participation

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

O.L.G. Atigossou was granted a scholarship by the Provincial Rehabilitation Research Network (REPAR) and is currently supported by a doctoral scholarship from the Quebec Health Research Funds. Salary support was provided to Alexandre Campeau-Lecours and François Routhier by the Quebec Health Research Funds (Junior 2 and Senior, respectively).

Notes on contributors

Orthelo Léonel Gbètoho Atigossou

Orthelo Léonel Gbètoho Atigossou, P T, MSc, is a PhD candidate in Clinical Medicine and Biomedical Sciences at Université Laval. His doctoral research is focused on the impacts of assistive technologies for people with disabilities, under the supervision of Véronique H Flamand and François Routhier.

Marie-Hélène Demers

Marie-Hélène Demers, OT, and Marie-Philippe Paquet, OT, were Master’s students in the Occupational Therapy Program at Université Laval and research assistants at the Center for Interdisciplinary Research in Rehabilitation and Social Integration under the supervision of Véronique H Flamand at the time of the study.

Marie-Philippe Paquet

Marie-Hélène Demers, OT, and Marie-Philippe Paquet, OT, were Master’s students in the Occupational Therapy Program at Université Laval and research assistants at the Center for Interdisciplinary Research in Rehabilitation and Social Integration under the supervision of Véronique H Flamand at the time of the study.

Isabelle Bradet-Levesque

Isabelle Bradet-Levesque, OT, MSc, was a Master’s student in the Clinical Medicine and Biomedical Sciences Program at Université Laval under the supervision of Véronique H Flamand at the time of the study.

Alexandre Campeau-Lecours

Alexandre Campeau-Lecours, Eng, PhD, is an Associate Professor at Université Laval and a researcher at the Center for Interdisciplinary Research in Rehabilitation and Social Integration. His research interests include the development of advanced technologies to assist people with disabilities, and the integration of these technologies into rehabilitation.

François Routhier

François Routhier, Eng, PhD, is a full Professor at Université Laval and a researcher at the Center for Interdisciplinary Research in Rehabilitation and Social Integration. His research interests lie in the development and evaluation of assistive technologies to improve mobility and social participation in individuals with disabilities.

Véronique H. Flamand

Véronique H. Flamand, OT, PhD, is an Associate Professor at the School of Rehabilitation Sciences at Université Laval and a researcher at the Center for Interdisciplinary Research in Rehabilitation and Social Integration. Her research is focused on the development and evaluation of clinical interventions in individuals with upper extremity impairments, including the development and assessment of assistive technologies, in terms of independence and participation.