Date Presented 04/05/2025
This systematic review evaluates evidence on using robotic therapy for upper extremity rehabilitation for individuals with chronic stroke to determine its effectiveness in improving function and pain and to determine the costs of therapy and dosage.
Primary Author and Speaker: Rochelle Mendonca
Additional Authors and Speakers: Amy A. Lopez, Esmé Dmitra Erdynast, Monique Allen, Megan Vosberg, Namrata Grampurohit
PURPOSE: Stroke impacts about 795,000 Americans annually. This study reviews the literature to determine the effectiveness of robotic therapy on upper limb function and pain in adults with chronic stroke compared to conventional therapy.
DESIGN: A systematic review was conducted on six databases. Inclusion criteria were peer-reviewed randomized trials published between 2007-2023, adults aged 18+, chronic stroke, upper extremity pain and function, and robots.
METHOD: Screening and full-text review were completed independently by two reviewers with a third reviewer for consensus using Rayyan. Data extraction included title, author, date, setting, age, time post-stroke, type of stroke, inclusion & exclusion criteria, participants, study design, robotic intervention, alternate intervention, and outcomes. Risk of bias was assessed using PEDro and CONSORT. Strength of evidence was assessed using AJOT guidelines.
RESULTS: 6429 articles were reviewed and 42 randomized trials were included for full-text review. Preliminary results of Level 1B articles showed significant between-group improvements in the robot group compared to control group on UE functional assessments: the Fugl Meyer (FM), Action Research Arm Test (ARAT), Wolf Motor Function Test (WMFT), and Stroke Impact Scale (SIS). Within-group differences were seen from pre to post testing on the FM, MAL, SMFT, SIS, Nottingham Extended ADL Scale (NEADL), and ABILHAND for both groups. Level 2B studies showed within-group differences for the robot group on the FM, SIS, ARAT, MAL, Box and Block Test, strength, and range of motion. No differences were found in pain outcomes. Dosage of robotic intervention ranged from 20-300 hours for robot therapy.
CONCLUSION: Robotic therapy has positive outcomes on function of adults with chronic stroke compared to conventional therapy. Use of robotic therapy in conjunction with OT increases opportunities for the advancement of current upper extremity interventions.
References
Cho, K.-H., & Song, W.-K. (2020). Effects of two different robot-assisted arm training on upper limb motor function and kinematics in chronic stroke survivors: A randomized controlled trial. Topics in Stroke Rehabilitation, 28(4), 241–250. https://doi.org/10.1080/10749357.2020.1804699
Takebayashi, T., Takahashi, K., Amano, S., Gosho, M., Sakai, M., Hashimoto, K., Hachisuka, K., Uchiyama, Y., & Domen, K. (2022). Robot-assisted training as self-training for upper-limb hemiplegia in chronic stroke: A randomized controlled trial. Stroke, 53(7), 2182–2191. https://doi.org/10.1161/strokeaha.121.037260
