Robot-assisted distal training improves upper limb dexterity and function after stroke: a systematic review and...

Area of Science:

• Neurorehabilitation
• Robotics in Medicine
• Stroke Recovery

Background:

• Stroke is a leading cause of death and disability worldwide.
• Distal upper extremity dysfunction is a common and debilitating consequence for stroke survivors.
• Robot-assisted training shows potential for enhancing motor recovery in the upper limbs.

Purpose of the Study:

• To systematically review and meta-analyze the effect of robot-assisted distal training on motor function, hand dexterity, and spasticity post-stroke.
• To compare the efficacy of robot-assisted distal training against conventional therapy.

Main Methods:

• Systematic search of eleven databases for randomized controlled trials (RCTs) up to August 28, 2021.
• Inclusion of twenty-two RCTs with 758 participants.
• Meta-analysis and meta-regression to assess overall effects and sources of heterogeneity.

Main Results:

• Robot-assisted distal training significantly improved wrist and hand motor function (MD = 3.92).
• Significant benefits were observed in other motor functions (MD = 2.84), dexterity (MD = 9.01), upper extremity strength (SMD = 0.42), and daily living activities (SMD = 0.70).
• Subgroup analyses indicated optimal training designs and regimens, with meta-regression highlighting the impact of trial year, country, and duration.

Conclusions:

• Robot-assisted distal training demonstrates significant efficacy in improving upper extremity motor function, dexterity, and reducing spasticity in stroke patients.
• This robotic approach offers a superior alternative to conventional therapy for post-stroke rehabilitation of the upper limb.