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Robot-assisted upper and lower limb rehabilitation after stroke: walking and arm/hand function

Dtsch Arztebl Int. 2008 May;105(18):330-6. doi: 10.3238/arztebl.2008.0330. Epub 2008 May 2.

Abstract

Introduction: Robots help to intensify motor rehabilitation of the upper and lower limbs after stroke. This article presents controlled studies relating to this topic, and an overview.

Methods: A search was carried out for relevant randomized controlled trials, published between 1980 and 2007, on Medline (PubMed), Embase, and CINHAL.

Results: Two studies showed benefit for an electromechanical gait trainer, with significantly more patients resuming walking as compared to conventional physiotherapy. Two studies showed no evidence of benefit for an exoskeleton-based system. A pooled analysis was not conducted due to the small numbers of studies and high heterogeneity. In arm/hand rehabilitation a number of unilateral or bilateral end-effector based systems proved effective in patients with stroke, and a simple one-dimensional system and a passive exoskeleton system proved effective in patients with chronic symptoms.

Discussion: Robot-assisted motor rehabilitation after stroke appears promising. More trials, including comparative studies, are mandatory. The robot cannot be considered a substitute for the patient-therapist relationship.

Keywords: hemiparesis; physiotherapy; rehabilitation; robotics; stroke.