Samuelkamaleshkumar Selvaraj, Annpatriciacatherine Suresh, Jithu Abrahamalex, Jeromedanypraveenraj Jones, Senthilvelkumar Thangavelu, Augustine Thomas Anand, Chalageri Prashanth H, George Jacob, Thomas Raji
Department of Physical Medicine & Rehabilitation, Christian Medical College, Vellore, Tamil Nadu, India.
Department of Physical Medicine & Rehabilitation, Christian Medical College, Vellore, Tamil Nadu, India.
Arch Phys Med Rehabil. 2025 Mar;106(3):424-432. doi: 10.1016/j.apmr.2024.09.014. Epub 2024 Oct 11.
To examine robotic interventions for upper limb rehabilitation poststroke, focusing on geographic distribution, stroke chronicity, outcome measures, outcomes of robotic interventions, and publication trends in low- and middle-income countries (LMICs) compared with high-income countries (HICs).
Using Joanna Briggs Institute methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines, PubMed, CENTRAL, Embase, CINAHL, and PEDro databases were searched for studies on upper extremity rehabilitation with robotics poststroke.
This review focused on randomized controlled trials (RCTs) published between 2012 and 2024 that examined rehabilitation robots for upper limb impairments caused by stroke. The studies included adults aged ≥18 years in the acute, subacute, or chronic recovery phases. Eligible trials involved using robotic devices, independently or combined with other interventions. Only RCTs with 2 or more arms were considered, and all included studies were published in English.
Reviewers independently extracted data on study characteristics, stroke chronicity, outcome measures, outcomes of robotic interventions, and temporal trends.
Of 129 articles meeting the criteria, 107 were from HICs, and 22 were from LMICs. Major contributors from HICs included Italy, Taiwan, and the USA, whereas China was a significant contributor among LMICs. Most studies focused on patients with chronic stroke, with varying assessment tools, the most common being the Fugl-Meyer Upper Extremity Evaluation. Positive outcomes were reported across studies, and recent research activity has increased in both settings.
This review underscores the expanding research on robotic therapy for upper limb rehabilitation in patients with stroke, primarily from HICs with limited input from low- and middle-income nations. Although positive outcomes were frequently observed, disparities between high-income and low-and middle-income countries were clear. The growing research indicates rising interest and advancements in this domain.
研究用于中风后上肢康复的机器人干预措施，重点关注地理分布、中风病程、结局指标、机器人干预的效果，以及与高收入国家（HICs）相比，低收入和中等收入国家（LMICs）的发表趋势。
采用乔安娜·布里格斯研究所的方法以及系统评价和Meta分析扩展版的首选报告项目（PRISMA-ScR）指南，检索了PubMed、CENTRAL、Embase、CINAHL和PEDro数据库中关于中风后上肢康复机器人研究的文献。
本综述聚焦于2012年至2024年间发表的随机对照试验（RCT），这些试验研究了用于中风所致上肢功能障碍的康复机器人。研究纳入了处于急性、亚急性或慢性恢复阶段且年龄≥18岁的成年人。符合条件的试验包括单独使用机器人设备或与其他干预措施联合使用。仅考虑具有两个或更多组的RCT，所有纳入研究均以英文发表。
reviewers独立提取了关于研究特征、中风病程、结局指标、机器人干预的效果以及时间趋势的数据。
在符合标准的129篇文章中，107篇来自高收入国家，22篇来自低收入和中等收入国家。高收入国家的主要贡献者包括意大利、台湾地区和美国，而中国是低收入和中等收入国家中的重要贡献者。大多数研究聚焦于慢性中风患者，评估工具各不相同，最常用的是Fugl-Meyer上肢评估。各项研究均报告了积极的结果，并且近期在这两种情况下的研究活动都有所增加。
本综述强调了中风患者上肢康复机器人疗法的研究不断扩展，主要来自高收入国家，低收入和中等收入国家的投入有限。尽管经常观察到积极的结果，但高收入国家与低收入和中等收入国家之间的差距明显。不断增加的研究表明该领域的兴趣和进展在不断上升。
