RESUMEN
The human hand is a crucial anatomical structure, and its complexity enables humans to grasp tools essential for daily life activities. Consequently, hand disabilities have a negative and profound impact on people's autonomy in performing everyday tasks. The Nuada Glove (Nuada, Braga, Portugal) is a wearable exoskeleton robotic device designed to assist individuals with hand impairments or weakness in regaining hand function, particularly in grasping movements. This pilot study aims to evaluate its impact on improving hand function in first-time users with hand disabilities and to assess its usability. A total of 63 participants with hand disabilities were asked to complete a series of exercises that simulated various human grasping motions, initially without any assistance and then with the Nuada Glove. Of the participants, 98% exhibited measurable improvement in hand function in at least one exercise. This pilot study, conducted in a controlled environment, clearly demonstrated the benefits of the Nuada Glove and its ease of use. Future studies should expand from this one to assess the use of the Nuada Glove in a real-world environment with continuous use.
RESUMEN
Muscle injuries commonly occur in sports and can be classified as indirect and direct, according to the 2013 Munich Consensus Statement (MCS). Since recent evidence suggests that extracorporeal shock wave therapy (ESWT) improves muscular microcirculation and may increase regeneration after acute muscle injury, we performed a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines to access the efficacy and safety of ESWT in the treatment of patients with muscle injuries. PubMed and Cochrane were searched to screen for potentially relevant articles and the literature search was last updated in June 2023. The inclusion criteria were randomized controlled trials, observational studies, or case controls published in English, Portuguese, or Spanish that studied the effect of ESWT on indirect and direct muscle injuries in individuals aged ≥18, with at least one of the following reported outcomes: pain on the visual analog scale (VAS), functionality assessed either with disability scales or subjectively, time for return to play (RTP), re-injury rate, and ultrasonographic evaluation. The exclusion criteria were literature reviews, systematic reviews, studies in animals, studies in other languages, studies that failed to meet the targeted population or intervention and studies that didn't report any of the outcomes of interest. The quality of the studies was analyzed using the Cochrane Assessment Tool, the Newcastle-Ottawa Quality Assessment Scale, and the JBI Critical Appraisal Checklist. Eight studies were included in the systematic review (two randomized controlled trials, one prospective observational study, two retrospective observational studies, and three case reports), with a total of 143 adult participants. ESWT was associated with less pain on VAS, better function, reduction of size of lesion on ultrasound evaluation, faster RTP and/or lower re-injury rate in patients with indirect and direct muscle injuries and muscular hematomas, a frequent secondary complication of muscle injuries. The evidence regarding the use of ESWT for these types of injuries is therefore promising. Nevertheless, higher-quality studies are needed in the future to prove its efficacy, better comprehend its mechanisms of action and define treatment protocols (timing, type and parameters of ESWT).
