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

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.

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