Robotic arm use for upper limb rehabilitation after stroke: A systematic review and meta‐analysis

Abstract

Several studies have reported the effects of robotic arms on improving upper limb function in patients with stroke. However, previous studies have reported inconsistent findings that may lead to incorrect applications of robotic arm use. Six databases were searched for relevant randomized controlled trials. Meta-analyses were performed for upper limb performance measures, including subgroup analysis of pooled upper limb rehabilitation data such as stroke stage and intervention delivery dose.Furthermore, the Cochrane risk-of-bias tool for randomized trials version 2 (RoB 2) and sensitivity analysis were used to assess methodology and determine publication bias. The final analysis included 18 studies. Robotic arms improved upper limb and hand function in patients with stroke. Subgroup analysis revealed that robotic arm interventions lasting 30-60 min per session significantly improved upper limb function. However, no significant improvement was observed in shoulder and elbow or wrist and hand movements. This review may help develop applicable rehabilitation robots and collaboration between clinicians.

Enhancing Stroke Rehabilitation with Whole-Hand Haptic Rendering: Development and Clinical Usability Evaluation of a Novel Upper-Limb Rehabilitation Device

“…This combination enhances patient enjoyment [19] and the provision of real-time performance feedback that allows therapists to adapt the training to the patient's individual needs [20]. When compared to dose-matched conventional therapy, some studies point to improved outcomes with robotic interventions [17,21,22], while a large body of research indicates that robotic therapy is currently non-inferior to conventional interventions [15,[23][24][25][26].…”

Optimizing shoulder elevation assist rate in exoskeletal rehabilitation based on muscular activity indices: a clinical feasibility study

“…A previous study reported that higher-intensity robotic therapy exercises improved upper-extremity impairment after stroke [ 9 ]. However, the effectiveness of robotic therapy has focused on the distal hand and fingers, and no significant efficacy of robotic therapy for hemiplegic shoulders has been elucidated [ 10 ]. In particular, it is difficult to safely assist shoulder elevation against gravity (vertical movement) through robotic intervention because of the complex musculoskeletal anatomy of the shoulder.…”

Research Status and Prospect of Finger Rehabilitation Machinery

“…Scientific studies have shown that continuous passive rehabilitation exercise therapy can effectively prevent muscle atrophy, promote the remodeling of nervous system motor function, 3–9 prevent tendon adhesion and joint stiffness, and improve blood circulation and joint rehabilitation effects at the exercise site, to achieve the treatment of finger. 10 , 11 Finger rehabilitation machinery has become a key research direction of international rehabilitation engineering and robotics, and patients can carry out efficient autonomous rehabilitation training by wearing manipulators. 12–14 …”