A Cochrane review [Abstract] 1 included 34 studies with a total of 1160 subjects. The effectiveness of electromechanical and robot-assisted arm training for stroke patients was compared with other rehabilitation interventions or no treatment. Duration of studies ranged from 2 to 12 weeks. Electromechanical and robot-assisted arm training improved activities of daily living scores (SMD 0.37, 95% CI 0.11 to 0.64, p = 0.005), arm function (SMD 0.35, 95% CI 0.18 to 0.51, p < 0.0001), and arm muscle strength (SMD 0.36, 95% CI 0.01 to 0.70, p = 0.04). Electromechanical and robot-assisted arm training did not increase the risk of participant drop-out (RD 0.00, 95% CI -0.02 to 0.03, P = 0.84) and adverse events were rare.
Comment: The quality of evidence is downgraded by inconsistency (heterogeneity in patients, interventions and outcomes) and indirectness (short follow-up time).
A systematic review including 9 RCTs with 218 participants was abstracted in DARE 2. Studies evaluated the effect of robot-assisted therapy on motor and/or functional recovery of a paretic arm in stroke patients. Five different devices were compared with robot exposure or conventional therapy. Intervention time ranged from 4 to 12 weeks and therapy started from one week to more than 6 months after the stroke. Most studies used the Fugl-Meyer tool to assess motor recovery and the Functional Independence Measure to assess function (activities of daily living). Robot-assisted therapy was not superior to control for motor recovery (weighted summary effect size [SES] 0.65, 95% CI -0.02 to 1.33) or functional recovery (SES 0.13, 95% CI -0.23 to 0.5). The mean daily intervention time was longer for robotic therapy compared with control groups and this may have influenced the results.
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