Robot-assisted therapy following stroke: what effects on quality of life, cognitive and psychosocial outcomes? A systematic review.

No meta-analysis was conducted due to substantial heterogeneity in study designs, participant profiles, intervention features, and outcome measures. In most included studies, non-motor outcomes were assessed as secondary or exploratory measures rather than primary endpoints, limiting statistical power. Follow-up evaluations were rare and generally short, with most lasting less than six months, making it impossible to determine if non-motor benefits persist long-term. The review included many small studies, with 26.7% involving fewer than 30 participants, and most studies lacked blinding of patients, providers, and outcome assessors. Participants were predominantly men aged under 65 years, and only two studies reported ethnicity, limiting generalizability to older adults, women, and diverse populations. The contribution of robot-assisted therapy versus concurrent interventions like virtual reality or conventional therapy could not be separated in many studies.

The authors declared no conflicts of interest. The project was funded by the Italian Ministry of University and Research.

Do not interpret the high proportion of positive findings as evidence that robot-assisted therapy produces lasting non-motor benefits. Most studies measured quality of life, cognition, and psychosocial outcomes as secondary endpoints, and the few follow-up evaluations available showed no significant long-term effects.