SYSTEMATIC REVIEW article
Front. Neurol.
Sec. Neurorehabilitation
This article is part of the Research TopicNeurorehabilitative and regenerative methods involved in treating traumatic brain and spinal cord injuries: Volume IIView all 10 articles
Effects of Robotic-Assisted Upper Extremity Therapy for Stroke Patients in Different Recovery Phases: A Systematic Review and Meta-Analysis
Provisionally accepted
- Lanzhou University Second Hospital, Lanzhou, China
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Objective: To systematically evaluate the efficacy of robotic-assisted therapy on upper extremity recovery after stroke through stratified meta-analysis, assessing the influence of disease phase, injury severity, device type, training parameters, and follow-up duration. Methods: We conducted a systematic literature search of PubMed, Embase, Cochrane Library, and Web of Science from inception to July 2025 for randomized controlled trials (RCTs) comparing robotic-assisted with conventional upper limb therapy in adult stroke patients. Results: Analysis of 42 RCTs (n=1,678) demonstrated that robotic-assisted therapy significantly improved motor function (Fugl-Meyer Upper Extremity Motor Assessment (FMA-UE)), grip strength (GS), activities of daily living (Modified Barthel Index (MBI)), and social participation (Stroke Impact Scale (SIS)) compared to conventional therapy. Crucially, patients in the subacute phase and those with severe impairment achieved clinically meaningful recovery, with improvements in motor function (FMA-UE: WMD = 8.82, 95% CI (4.42, 13.23)) and activities of daily living (MBI: WMD = 8.00, 95% CI (4.96, 11.03)) exceeding established Minimal Clinically Important Difference (MCID) thresholds. Conclusions: Robotic-assisted therapy significantly improves upper extremity motor function and activities of daily living after stroke, with clinically meaningful gains particularly evident in subacute patients and those with severe impairment. Benefits in grip strength and social participation were statistically significant but of uncertain clinical importance due to methodological limitations. These findings support a stratified rehabilitation approach, prioritizing subacute and severely impaired patients for robotic intervention to maximize functional outcomes.
Keywords: stroke1, upper extremity2, robotics3, rehabilitation4, neuronal plasticity5, Randomized controlled tria6, meta-analysis7
Received: 03 Jun 2025; Accepted: 11 Dec 2025.
Copyright: © 2025 Wang, Li, Liu, Zhang and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xiaoling Li
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