Effectiveness of Robot-Assisted Upper Extremity Function Training (Gloreha) on Upper Extremities Function After Stroke: Systematic Review.

Only 3 trials with 83 participants total, so the evidence base is very thin and the findings are preliminary. The intervention protocols differed substantially across trials: different Gloreha modes (passive vs active-assisted), different session lengths (30 to 60 minutes), different frequencies (2 to 5 times per week), and different total durations (3 to 6 weeks). Participants were in different phases of recovery: two trials enrolled people in the acute to subacute phase (under 3 months post stroke) and one enrolled people in the chronic phase (over 6 months), and the authors note that rehabilitation effects may differ by chronicity. One trial (Lee) had some concerns about risk of bias because participant dropout may have been related to the intervention context. The ADL scales used (Barthel Index) may lack the sensitivity to detect subtle functional changes, and the total Gloreha training dose in these studies was under 15 hours, below a threshold the authors cite for translating motor gains into functional gains. No long-term follow-up data were available; all trials measured outcomes only at baseline and post-intervention.

No conflicts of interest declared by the authors. No funding source is named in the text.

Do not read the motor score improvements as proof that Gloreha improves daily living. Both trials that measured ADLs found no significant difference between the Gloreha group and the conventional therapy group. The entire evidence base is 3 small trials with 83 participants, and in two of those trials the Gloreha was added on top of standard therapy rather than replacing it, so the gains cannot be attributed to the device alone.