Systematic review and meta-analysis of effectiveness of robotic therapy in the recovery of motor functions after stroke

BackgroundStroke is a leading cause of adult disability worldwide, often resulting in persistent motor impairments. While conventional rehabilitation approaches often yield modest results, robotic-assisted therapy has emerged as a promising solution to enhance motor recovery. However, the impact of...

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Main Authors: Mariyam Amirbekova, Tokzhan Kispayeva, Ausra Adomaviciene, Laura Eszhanova, Inna Bolshakova, Zhanna Ospanova
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Human Neuroscience
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Online Access:https://www.frontiersin.org/articles/10.3389/fnhum.2025.1622661/full
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author Mariyam Amirbekova
Tokzhan Kispayeva
Tokzhan Kispayeva
Ausra Adomaviciene
Laura Eszhanova
Inna Bolshakova
Zhanna Ospanova
author_facet Mariyam Amirbekova
Tokzhan Kispayeva
Tokzhan Kispayeva
Ausra Adomaviciene
Laura Eszhanova
Inna Bolshakova
Zhanna Ospanova
author_sort Mariyam Amirbekova
collection DOAJ
description BackgroundStroke is a leading cause of adult disability worldwide, often resulting in persistent motor impairments. While conventional rehabilitation approaches often yield modest results, robotic-assisted therapy has emerged as a promising solution to enhance motor recovery. However, the impact of stroke phase (acute, subacute, chronic) and other clinical modifiers on the effectiveness of robotic rehabilitation remains underexplored.MethodsThe protocol for this systematic review and meta-analysis was registered in PROSPERO under the registration number CRD420251038754. A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. The literature search was conducted using MEDLINE, PubMed, Cochrane Library, Scopus, Web of Science, and EMBASE. Risk of bias was assessed using the RoB 2.0. Primary outcomes included motor recovery, gait speed, and balance. A random-effects model (DerSimonian-Laird) was applied to calculate pooled standardized mean differences (SMD), and subgroup analyses and meta-regression were used to assess the influence of stroke phase, age, therapy duration, and combined interventions (e.g., virtual reality, mirror therapy).ResultsThirteen randomized controlled trials (RCTs) published between 2015 and 2025 were included, with a total of 424 post-stroke patients. Robotic therapy showed a moderate but statistically significant effect over conventional rehabilitation (SMD = 0.59, 95% CI: [0.33; 0.84], p < 0.001), with low-to-moderate heterogeneity (I2 = 30.5%). Subgroup analysis revealed the strongest effects during the subacute phase (SMD = 0.74) and acute phase (SMD = 0.75), while the chronic phase yielded limited improvement (SMD = 0.23). Younger age and a intervention duration of more than 6 weeks were associated with enhanced outcomes. Meta-regression indicated a trend toward reduced effectiveness with prolonged intervention duration (β = −0.134), although not statistically significant (p = 0.102). No publication bias was detected (Egger’s p = 0.56).ConclusionRobotic-assisted therapy provides clinically meaningful improvements in post-stroke motor recovery. The findings support early stratification and personalization of rehabilitation programs based on stroke timing, age, and intervention intensity. Integration of robotic systems with virtual and cognitive components may further enhance neuroplasticity, leading to improved functional outcomes.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251038754.
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spelling doaj-art-086c93a866cf4e17b4c68abff0e110ae2025-08-20T02:41:42ZengFrontiers Media S.A.Frontiers in Human Neuroscience1662-51612025-07-011910.3389/fnhum.2025.16226611622661Systematic review and meta-analysis of effectiveness of robotic therapy in the recovery of motor functions after strokeMariyam Amirbekova0Tokzhan Kispayeva1Tokzhan Kispayeva2Ausra Adomaviciene3Laura Eszhanova4Inna Bolshakova5Zhanna Ospanova6Institute of Life Sciences, Karaganda Medical University, Karaganda, KazakhstanSchool of Nursing Education, Karaganda Medical University, Karaganda, KazakhstanRehabilitation Center “Neuron”, Karaganda, KazakhstanDepartment of Rehabilitation, Institute of Medical Sciences, Physical and Sports Medicine, Vilnius University, Vilnius, LithuaniaDepartment of Neurology, Medical University of Astana, Astana, KazakhstanSchool of Nursing Education, Karaganda Medical University, Karaganda, KazakhstanDepartment of History of Kazakhstan and Socio-Political Disciplines, Karaganda Medical University, Karaganda, KazakhstanBackgroundStroke is a leading cause of adult disability worldwide, often resulting in persistent motor impairments. While conventional rehabilitation approaches often yield modest results, robotic-assisted therapy has emerged as a promising solution to enhance motor recovery. However, the impact of stroke phase (acute, subacute, chronic) and other clinical modifiers on the effectiveness of robotic rehabilitation remains underexplored.MethodsThe protocol for this systematic review and meta-analysis was registered in PROSPERO under the registration number CRD420251038754. A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. The literature search was conducted using MEDLINE, PubMed, Cochrane Library, Scopus, Web of Science, and EMBASE. Risk of bias was assessed using the RoB 2.0. Primary outcomes included motor recovery, gait speed, and balance. A random-effects model (DerSimonian-Laird) was applied to calculate pooled standardized mean differences (SMD), and subgroup analyses and meta-regression were used to assess the influence of stroke phase, age, therapy duration, and combined interventions (e.g., virtual reality, mirror therapy).ResultsThirteen randomized controlled trials (RCTs) published between 2015 and 2025 were included, with a total of 424 post-stroke patients. Robotic therapy showed a moderate but statistically significant effect over conventional rehabilitation (SMD = 0.59, 95% CI: [0.33; 0.84], p < 0.001), with low-to-moderate heterogeneity (I2 = 30.5%). Subgroup analysis revealed the strongest effects during the subacute phase (SMD = 0.74) and acute phase (SMD = 0.75), while the chronic phase yielded limited improvement (SMD = 0.23). Younger age and a intervention duration of more than 6 weeks were associated with enhanced outcomes. Meta-regression indicated a trend toward reduced effectiveness with prolonged intervention duration (β = −0.134), although not statistically significant (p = 0.102). No publication bias was detected (Egger’s p = 0.56).ConclusionRobotic-assisted therapy provides clinically meaningful improvements in post-stroke motor recovery. The findings support early stratification and personalization of rehabilitation programs based on stroke timing, age, and intervention intensity. Integration of robotic systems with virtual and cognitive components may further enhance neuroplasticity, leading to improved functional outcomes.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251038754.https://www.frontiersin.org/articles/10.3389/fnhum.2025.1622661/fullrobotic therapystroke recoverymeta-analysisneurorehabilitationmotor functions
spellingShingle Mariyam Amirbekova
Tokzhan Kispayeva
Tokzhan Kispayeva
Ausra Adomaviciene
Laura Eszhanova
Inna Bolshakova
Zhanna Ospanova
Systematic review and meta-analysis of effectiveness of robotic therapy in the recovery of motor functions after stroke
Frontiers in Human Neuroscience
robotic therapy
stroke recovery
meta-analysis
neurorehabilitation
motor functions
title Systematic review and meta-analysis of effectiveness of robotic therapy in the recovery of motor functions after stroke
title_full Systematic review and meta-analysis of effectiveness of robotic therapy in the recovery of motor functions after stroke
title_fullStr Systematic review and meta-analysis of effectiveness of robotic therapy in the recovery of motor functions after stroke
title_full_unstemmed Systematic review and meta-analysis of effectiveness of robotic therapy in the recovery of motor functions after stroke
title_short Systematic review and meta-analysis of effectiveness of robotic therapy in the recovery of motor functions after stroke
title_sort systematic review and meta analysis of effectiveness of robotic therapy in the recovery of motor functions after stroke
topic robotic therapy
stroke recovery
meta-analysis
neurorehabilitation
motor functions
url https://www.frontiersin.org/articles/10.3389/fnhum.2025.1622661/full
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