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Enhancing Motor Arm Function in Stroke Patients with UL- RTs

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The following is a summary of “Upper Limb Robots for Recovery of Motor Arm Function in Patients With Stroke: A Systematic Review and Meta-Analysis,” published in the June 2024 issue of Neurology by Iaco et al.


Robotic therapy for upper limb (UL) recovery after stroke has become a fast-growing field in recent years.

Researchers started a retrospective study to assess how UL-robots (UL-RTs) compared to non-UL-robot interventions affected upper limb motor function and capacity after stroke, also looking for factors linked to the observed effect sizes (ESs).

They conducted RCTs to compare UL-RTs with other interventions for patients with UL limitations poststroke. Electronic searches were performed on PubMed, Wiley/Cochrane Libraries, Embase, Cumulative Index of Nursing and Allied Health Literature, Web of Science, SportDISCUS, Physiotherapy Evidence Database (PEDro), and Google Scholar (August 1, 2022). Relevant data were independently extracted by two reviewers using Microsoft Excel. Meta-analyses assessed UL-muscle synergism, muscle power, muscle tone, capacity, self-reported motor performance, and basic activities of daily living (ADLs). Subgroup, sensitivity, and meta-regression analyses identified factors influencing ESs using Review Manager 5.4 or IBM SPSS Statistics 27.

The results included 90 RCTs (N = 4,311) with a median PEDro score of 6 [6–7]. Meta-analyses of 86 trials (N = 4,240) demonstrated small but significant improvements in UL-muscle synergism (Fugl-Meyer Assessment of the UL [FM-UL]) (MD 2.23 [1.11–3.35]), muscle power (SMD 0.39 [0.16–0.61]), motor performance (SMD 0.11 [0.00–0.21]), and basic ADLs (SMD 0.28 [0.10–0.45]). No overall effects were found for muscle tone (SMD −0.1 [−0.26 to 0.07]) or UL-capacity (SMD 0.04 [−0.10 to 0.18]), except with exoskeletons (SMD 0.27 [0.10–0.43]). Meta-regressions indicated a significant positive correlation between baseline mean FM-UL and ESs for UL-capacity (r = 0.339; P=0.03), particularly in the acute and early-subacute phases poststroke (r = 0.65; P=0.01). No further significant subgroup differences or associations were identified in the analyses.

Investigators concluded that while UL-RTs showed modest improvements in motor impairment, these did not translate to significant gains in real-world upper limb function.

Source: neurology.org/doi/10.1212/WNL.0000000000209495

The post Enhancing Motor Arm Function in Stroke Patients with UL- RTs first appeared on Physician's Weekly.


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