Effectiveness of Robotics in Stroke Rehabilitation to Accelerate Upper Extremity Function: Systematic Review

Area of Science:

• Neurorehabilitation
• Robotics in Medicine
• Stroke Recovery

Background:

• Stroke is a leading cause of long-term disability, particularly affecting upper extremity (UE) function.
• Conventional therapy (CT) is the standard for UE recovery, but advancements are sought to improve outcomes.
• Robot-assisted therapy (RAT) has emerged as a potential adjunct to CT, aiming to enhance motor function recovery.

Approach:

• A systematic review and meta-analysis was conducted to evaluate the effectiveness of RAT combined with CT versus CT alone for UE recovery poststroke.
• Inclusion criteria focused on randomized controlled trials (RCTs) in adults using the Fugl-Meyer Assessment (FMA) as an outcome measure.
• Searches were performed across five major databases (Ovid, MEDLINE, CINAHL, PubMed, Scopus) for studies published between January 2011 and May 2021.

Key Points:

• Current evidence suggests that RAT combined with CT may offer an initial advantage in accelerating UE recovery, as measured by FMA scores, early in the rehabilitation phase.
• The observed benefits of RAT appear to diminish over time, indicating a potential plateau or fading effect.
• Findings regarding the cost-benefit analysis of implementing RAT in clinical practice are inconclusive, highlighting the need for further economic evaluations.

Conclusions:

• While RAT shows promise for early-stage UE recovery poststroke, its long-term efficacy and cost-effectiveness require more robust investigation.
• Additional high-quality, controlled studies are necessary to validate the initial findings and inform widespread clinical adoption of RAT.
• The integration of RAT into stroke rehabilitation protocols warrants careful consideration of its evolving evidence base and economic implications.