Dose-response effects of robot-assisted training on poststroke functional recovery: A systematic review and meta-analysis.
Song Hu, Fengjiao Wang, Jia Liu et al.
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In 30 seconds
This systematic review and meta-analysis included 36 randomised controlled trials involving 1941 adults with stroke, comparing robot-assisted training (RAT), alone or with conventional rehabilitation, against conventional rehabilitation. RAT was associated with better upper-limb motor function (MD = 2.89, 95% CI: 1.49-4.28) and activities of daily living (standardized mean difference = 0.28, 95% CI: 0.13-0.43), but not balance. Analyses found no significant linear or nonlinear relationship between five training-dose parameters and the assessed outcomes, so the review does not establish an optimal dose.
Key findings
- RAT improved upper-limb motor function compared with conventional rehabilitation (MD = 2.89, 95% CI: 1.49-4.28).
- RAT improved activities of daily living (standardized mean difference = 0.28, 95% CI: 0.13-0.43).
- Balance did not improve significantly (MD = 1.27, 95% CI: -0.92 to 3.47).
- No significant linear or nonlinear dose-effect relationships were found for the assessed rehabilitation outcomes.
Why it matters
The findings suggest that RAT may support upper-limb recovery and daily functioning after stroke, while evidence for balance benefit is not demonstrated. The absence of a detected dose-response relationship means the included evidence does not identify a training dose that reliably produces greater gains. This distinction is relevant when interpreting RAT’s potential benefits and the uncertainty around how much training is needed.
What to keep in mind
Dose-related findings warrant caution: some subgroups included few studies, and actual training dose was incompletely reported. Evidence certainty was low for balance outcomes.