Identifying needs in adult rehabilitation to support the clinical implementation of robotics and allied technologies: an Italian national survey

Introduction: Robotics and technological interventions are increasingly being explored as solutions to improve rehabilitation outcomes but their implementation in clinical practice remains very limited. Understanding patient needs is crucial for effective integration of these technologies, ensuring they align with and address the actual requirements of individuals in clinical settings. The primary aim of this study is to explore the rehabilitation needs of adults with motor, sensory, and/or cognitive disabilities in order to more effectively guide the practice of technological and robotic interventions in clinical setting. Methods: To this end, as part of the Fit for Medical Robotics Initiative, we conducted a survey targeting adult patients recruited from clinical centers participating in the Initiative. It aimed to provide a clear understanding of the patients' rehabilitation priorities, as well as perceived efficacy and satisfaction levels about the robotic and the traditional rehabilitation, in order to better address trials on the use of robots and technologies in individuals with disabilities considering a patient-centered perspective. The survey was structured on the basis of the International Classification of Functioning, Disability, and Health framework. Results: There were 424 respondents representing a range of conditions, including stroke, Parkinson's disease, multiple sclerosis, neuromuscular disorders, and other motor and cognitive impairments. Notably, 86% of respondents reported undergoing traditional rehabilitation, while 39% had experienced (also) robotic interventions, highlighting limited accessibility to advanced rehabilitation technologies. Additionally, respondents expressed a significant need for multidomain rehabilitation, with movement being the most prioritized domain. The degree of satisfaction was higher among respondents receiving technological interventions, particularly in addressing mobility. Furthermore, a substantial proportion of respondents indicated a strong need for receiving home-based care. Discussion: The patient needs identified through the survey were fundamental for designing pragmatic clinical trials, whose results will help shape the rehabilitation offer using new and innovative models.