Use of robots in rehabilitative treatment

Assistive technology on upper extremity function for stroke patients: A systematic review with meta-analysis

BACKGROUND

In stroke rehabilitation, the selection of appropriate assistive devices is of paramount importance for patients. Specifically, the choice of device can significantly influence the functional recovery of the upper limb, impacting their overall activities or functional tasks.

OBJECTIVES

This review aimed to comprehensively analyze and summarize the clinical evidence from randomized controlled trials (RCTs) regarding the therapeutic effects of commonly used assistive devices on upper extremity function in patients with stroke.

METHODS

To evaluate assistive devices for patients with stroke, we summarized qualitatively throughout synthesis of results, such as therapeutic intervention, intensity, outcome, and summary of results, and examined risk of bias, heterogeneity, mean difference, 95% confidence interval, and I-squared value. To analyze, we used RoB 2 and RevMan 5.4.

RESULTS

The qualitative synthesis included 31 RCTs. The randomization process and the reporting of results showed minimal bias, but there were issues with bias from intended interventions, and missing outcome data presented some concerns. The quantitative synthesis included 16 RCTs. There was a significant difference in the Fugl-Meyer assessment-upper extremity functioning (FMA-UE) scores between the groups, with a total mean difference (95% confidence interval) of 2.40 (0.21, 4.60), heterogeneity values were Tau2 = 0.32, chi-square = 8.22, degrees of freedom = 8 (p = 0.41), and I2 = 3% for FMA-UE and the test for the overall effect produced Z = 2.14 (p = 0.03) in patients with chronic stroke. However, there was no significant difference in all other outcome measures.

CONCLUSIONS

Upper-limb robots did not demonstrate significant superiority over conventional treatments in improving function of upper limbs, with the exception of FMA-UE scores for patients with chronic stroke. The mean difference of FMA-UE was also lower than minimally important difference. Nonetheless, the usage of upper-limb robots may contribute to enhanced function for patients with stroke, as those devices support clinicians and enable a greater number of movement repetitions within specific time frames.

Is robot-assisted therapy effective in upper extremity recovery in early stage stroke? -a systematic literature review

[Purpose] The aim of this study was to systematically investigate the effects of robot-assisted therapy on the upper extremity in acute and subacute stroke patients. [Subjects and Methods] The papers retrieved were evaluated based on the following inclusion criteria: 1) design: randomized controlled trials; 2) population: stroke patients 3) intervention: robot-assisted therapy; and 4) year of publication: May 2012 to April 2016. Databased searched were: EMBASE, PubMed and COCHRAN databases. The Physiotherapy Evidence Database (PEDro) scale was used to assess the methodological quality of the included studies. [Results] Of the 637 articles searched, six studies were included in this systematic review. The PEDro scores range from 7 to 9 points. [Conclusion] This review confirmed that the robot-assisted therapy with three-dimensional movement and a high degree of freedom had positive effects on the recovery of upper extremity motor function in patients with early-stage stroke. We think that the robot-assisted therapy could be used to improve upper extremity function for early stage stroke patients in clinical setting.