Short and long-term effects of robot-assisted therapy on upper limb motor function and activity of daily living in patients post-stroke: a meta-analysis of randomized controlled trials.

The long-term comparison used few studies, so the lack of difference at follow-up may be underpowered. Most participants had first-ever stroke and ischemic stroke, so the results may not apply to recurrent stroke or hemorrhagic stroke. Therapists could not be blinded to the intervention, and many trials had unclear allocation concealment. The overall effect size was small or medium in some subgroups, so the clinical benefit was limited. Several trials combined robot-assisted therapy with usual care, conventional rehabilitation, arm exercise, physical therapy, occupational therapy, motor learning, self-guided therapy, task-oriented training or a home exercise program, so the pooled result cannot separate the robot component from the other therapy components. The analysis did not fully examine whether robot alone versus robot plus other therapy changed the result, or how repetitions, frequency and duration influenced effectiveness.

Do not read the result as proof that the robot itself caused the gain. In several trials, robot-assisted therapy was given together with usual care, conventional rehabilitation, arm exercise, physical therapy, occupational therapy, motor learning, self-guided therapy, task-oriented training or a home exercise program, and the pooled analysis cannot separate the robot from those components.