Introduction: The use of Information and Communication Technology (ICT) for assessing and treating cognitive and motor disorders is promoting home-based telerehabilitation. This approach involves ongoing monitoring within a motivating context to help patients generalize their skills. It can also reduce healthcare costs and geographic barriers by minimizing hospitalization. This systematic review focuses on investigating key aspects of telerehabilitation protocols for children with neurodevelopmental or neurological disorders, including technology used, outcomes, caregiver involvement, and dosage, to guide clinical practice and future research.Method: This systematic review adhered to PRISMA guidelines and was registered in PROSPERO. The PICO framework was followed to define the search strategy for technology-based telerehabilitation interventions targeting the pediatric population (aged 0–18) with neurological or neurodevelopmental disorders. The search encompassed Medline/PubMed, EMBASE, and Web of Science databases. Independent reviewers were responsible for selecting relevant papers and extracting data, while data harmonization and analysis were conducted centrally.Results: A heterogeneous and evolving situation emerged from our data. Our findings reported that most of the technologies adopted for telerehabilitation are commercial devices; however, research prototypes and clinical software were also employed with a high potential for personalization and treatment efficacy. The efficacy of these protocols on health or health-related domains was also explored by categorizing the outcome measures according to the International Classification of Functioning, Disability, and Health (ICF). Most studies targeted motor and neuropsychological functions, while only a minority of papers explored language or multi-domain protocols. Finally, although caregivers were rarely the direct target of intervention, their role was diffusely highlighted as a critical element of the home-based rehabilitation setting.Discussion: This systematic review offers insights into the integration of technological devices into telerehabilitation programs for pediatric neurologic and neurodevelopmental disorders. It highlights factors contributing to the effectiveness of these interventions and suggests the need for further development, particularly in creating dynamic and multi-domain rehabilitation protocols. Additionally, it emphasizes the importance of promoting home-based and family-centered care, which could involve caregivers more actively in the treatment, potentially leading to improved clinical outcomes for children with neurological or neurodevelopmental conditions.Systematic review registration: PROSPERO (CRD42020210663).

In bioinspired soft robotics, very few studies have focused on fluidic transmissions and there is an urgent need for translating fluidic concepts into realizable fluidic components to be applied in different fields. Nature has often offered an inspiring reference to design new efficient devices. Inspired by the working principle of a marine worm, the sipunculid species Phascolosoma stephensoni (Sipunculidae, Annelida), a soft linear fluidic actuator is here presented. The natural hydrostatic skeleton combined with muscle activity enables these organisms to protrude a part of their body to explore the surrounding. Looking at the hydrostatic skeleton and protrusion mechanism of sipunculids, our solution is based on a twofold fluidic component, exploiting the advantages of both pneumatic and hydraulic actuations and providing a novel fluidic transmission mechanism. The inflation of a soft pneumatic chamber is associated with the stretch of an inner hydraulic chamber due to the incompressibility of the liquid. Actuator stretch and forces have been characterized to determine system performance. In addition, an analytical model has been derived to relate the stretch ability to the inlet pressure. Three different sizes of prototypes were tested to evaluate the suitability of the proposed design for miniaturization. The proposed actuator features a strain equal to 40–50% of its initial length—depending on size—and output forces up to 18 N in the largest prototypes. The proposed bioinspired actuator expands the design of fluidic actuators and can pave the way for new approaches in soft robotics with potential application in the medical field.

Background: Nowadays, wearable sensors are widely used to quantify physical and motor activity during daily life, and they also represent innovative solutions for healthcare. In the clinical framework, the assessment of motor behaviour is entrusted to clinical scales, but they are dependent on operator experience. Thanks to their intrinsic objectivity, sensor data are extremely useful to provide support to clinicians. Moreover, wearable sensors are user-friendly and compliant to be used in an ecological environment (i.e., at home). This paper aims to propose an innovative approach useful to predict clinical assessment scores of infants’ motor activity. Materials and methods: Starting from data acquired by accelerometers placed on infants’ wrists and trunk during playtime, we exploit the method of functional data analysis to implement new models combining quantitative data and clinical scales. In particular, acceleration data, transformed into activity indexes and combined with baseline clinical data, represent the input dataset for functional linear models. Conclusions: Despite the small number of data samples available, results show correlation between clinical outcome and quantitative predictors, indicating that functional linear models could be able to predict the clinical evaluation. Future works will focus on a more refined and robust application of the proposed method, based on the acquisition of more data for validating the presented models. Trial registration number: ClincalTrials.gov; NCT03211533. Registered: July, 7th 2017. ClincalTrials.gov; NCT03234959. Registered: August, 1st 2017.

Background: Developmental Coordination Disorder (DCD) causes difficulties in postural control which are crucial to assess due to their impact on everyday life. There is a lack of suitable tools to acquire quantitative data and deeply analyze postural control, especially during the developmental age. The aim of this study is to investigate postural control skills in children with DCD and typically developing children (TD) using the Virtual Reality Rehabilitation System (VRRS). Methods: 18 children with DCD and 30 TD children (mean age 9.12 ± 2.65 and 7.12 ± 2.77 years, respectively) were tested by using the Movement Assessment Battery for Children Second Edition (MABC-2) and a VRRS stabilometric balance platform. A t-test was performed to identify differences in the VRRS parameters between the two groups. Furthermore, we investigated whether a correlation exists between the VRRS data and the MABC-2. Results: Significant differences (p < 0.05) in mean distance and frequency of the COP are found in the two groups. These parameters also correlate with the MABC-2 total score (p ≤ 0.05) and balance subscales (p ≤ 0.05). Conclusions: This study opens a new frontier for the assessment of postural skills in children with DCD and represents a potential basis for a tailored rehabilitation program, from which their postural stability and, consequently, their everyday life will benefit.

Unilateral Cerebral Palsy (UCP) is a clinical condition which mainly involves the movement and muscle tone of one side of the body, often impacting the general manual function. While there are some clinical assessment tools aimed to quantify the Upper Limbs (UpLs) use and the manual abilities, acquiring information regarding the motor abilities outside the clinical environment, such as the UpLs use and their asymmetry during daily life, could provide a more complete evaluation of the child and open a new clinical reasoning. For this purpose, wearable sensors are one of the newest approaches for continuously monitoring UpLs functions without being invasive. The aim of this study was to use wearable sensors to compare spontaneous/daily UpLs usage and asymmetry with the Assisting Hand Assessment (AHA) test, as well as comparing the daily UpLs usage behavior of children with UCP with respect to Typical Developing (TD) peers. Eighty children (54 with UCP and 26 TD) wore an Actigraph sensor on each wrist during the AHA test and then at least for the following week of daily life. The amount of use of each hand and the asymmetry were analyzed during both the AHA and the following week of daily life using linear regression analysis and ANOVA models. Significant relationships were found between the asymmetry detected during the week and both the AHA scores and the asymmetry detected during the test. UCP and TD children week asymmetry distributions were significantly different; moreover, some differences were found when grouping them by MACS levels. This paper proposes a new and easy technological methodology for monitoring UpLs behavior in daily life. Through wearable sensor data analysis, we demonstrate a linear correlation between asymmetry measured during smi-structured assessments and daily life. Additionally, we provide evidence of distinct patterns of UpLs usage between typically developing children and children with UCP in daily life. Clinical Trials.gov (NCT03054441).