PTOTMeta-AnalysisJournal of neuroengineering and rehabilitation2025

Upper limb robotic rehabilitation following stroke: a systematic review and meta-analysis investigating efficacy and the influence of device features and program parameters.

Kate Boardsworth, Usman Rashid, Sharon Olsen and 4 others

PMID 40671078

WHAT IT FOUND

Dose-matched robotic therapy gave a tiny, short-lived boost to arm capacity that patients did not feel in daily life.

It did not beat conventional therapy for activities. Games and feedback added nothing when a therapist supervised the session.

Key findings

01Robotic rehabilitation showed a statistically significant but small improvement in upper limb capacity immediately after treatment, which was not maintained at follow-up.

02There was no significant difference between robotic and conventional rehabilitation for activities of daily living at either post-intervention or follow-up.

03Subgroup analyses indicated that devices providing partial assistance, mobilising the distal upper limb, and using a single device were associated with larger effects on upper limb capacity.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

Only one study had a low overall risk of bias; most had concerns regarding randomisation, measurement, or reporting. The review was limited to English-language articles. Many included studies did not adequately report device features or intervention parameters, which restricted the depth of subgroup analysis. The small effect size for upper limb capacity was not clinically meaningful. Outcome measures varied, and some global measures may have been less sensitive to change than specific ones, potentially skewing subgroup results.

Declared interests

The text does not list specific funding sources or author conflicts of interest in the provided excerpts.

The easy way to misread this

Do not interpret the statistically significant improvement in upper limb capacity as a clinically useful outcome. The effect size was small, not maintained at follow-up, and did not translate to any improvement in the patient's ability to perform daily activities.

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