Effectiveness, social and wellbeing impact, and usability of environmental control systems for individuals with neurological conditions: a systematic review.

Purpose: Environmental control systems (ECS) are designed to assist people with disabilities live more independently by facilitating access to electronics devices around the home. These devices are prescribed and managed by healthcare services within the UK. Despite this there is limited evidence regarding their effectiveness. This review aims to provide an update on the state of evidence for ECS. Materials and methods: A systematic review was conducted using key words linked to ECSs and with a target population of individuals with neurological conditions. The search was conducted in the databases Embase and MEDLINE and covered articles published between 2011 and 2024. The abstracts were screened for inclusion and data extracted. The quality of the research was assessed by completing qualitative CASP checklists. Results: After screening seven articles were selected for inclusion in the review. There were no comparative studies; all were descriptive. Six articles reported increased independence. Impact on well-being and usability was reported across six and five studies respectively, with mixed results. Assessment using CASP checklists indicated the studies were of good quality within the limitations of non-experimental designs. Conclusions: There remains limited research in the ECS field. The evidence for the effectiveness, impact on wellbeing and usability of these devices remains weak. Future studies should consider before and after designs and control conditions to improve the evidence base.