{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T10:00:12Z","timestamp":1780653612467,"version":"3.54.1"},"reference-count":80,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:00:00Z","timestamp":1780617600000},"content-version":"vor","delay-in-days":155,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neural Plasticity"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Robot\u2010assisted upper\u2010limb rehabilitation is widely used after stroke, but links to neuroplasticity biomarkers remain uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To synthesize biomarker evidence after robot\u2010assisted upper\u2010limb training and quantify post\u2010intervention effects versus non\u2010robot comparators.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched PubMed, Web of Science, Embase, Cochrane Library, EBSCOhost, and Scopus from inception to December 31, 2025. Randomized controlled trials (RCTs) and nonrandomized intervention studies enrolling adults with stroke were eligible if they reported at least one neuroplasticity biomarker. Prespecified comparison classes were used; only the primary contrast (robot\u2010assisted training vs. non\u2010robot control) was pooled at post using DerSimonian\u2013Laird random\u2010effects models. Effects were expressed as standardized mean differences (SMDs; Hedges\u2019 g) or mean differences (MDs) with 95% confidence intervals (CIs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifty\u2010five studies, including 24 RCTs, were included. Four RCTs contributed to the primary quantitative synthesis, and each pooled endpoint included two or three trials. Robot\u2010assisted training was associated with improved ipsilesional resting motor threshold (RMT; SMD 1.77, 95% CI: 0.46\u20133.08;\n                      <jats:italic>k<\/jats:italic>\n                      \u2009=\u20092) and upper\u2010limb impairment (Fugl\u2013Meyer assessment\u2010upper extremity [FMA\u2010UE]; MD 4.48 points, 95% CI: 0.33\u20138.62;\n                      <jats:italic>k<\/jats:italic>\n                      \u2009=\u20093). Effects were uncertain for ipsilesional motor\u2010evoked potential (MEP) amplitude (SMD 0.52, 95% CI: \u22120.31\u20131.34;\n                      <jats:italic>k<\/jats:italic>\n                      \u2009=\u20092) and activities of daily living (ADL). Heterogeneity was moderate to substantial, prediction intervals crossed the null, and certainty was low or very low.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Robot\u2010assisted training may improve impairment and corticospinal excitability, but randomized biomarker evidence remains sparse and heterogeneous. Biomarkers should be interpreted as exploratory observations, not validated surrogates or causal evidence of cortical restitution.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/np\/9282578","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T09:01:14Z","timestamp":1780650074000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Robot\u2010Assisted Upper\u2010Limb Rehabilitation After Stroke: A Systematic Review and Meta\u2010Analysis of Cortical Reorganization and Neuroplasticity Biomarkers"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8566-3166","authenticated-orcid":false,"given":"Rocco Salvatore","family":"Calabr\u00f2","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5012-4425","authenticated-orcid":false,"given":"Andrea","family":"Calderone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lilla","family":"Bonanno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo","family":"Quartarone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonino","family":"Naro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro Marco","family":"De Nunzio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serena","family":"Filoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,5]]},"reference":[{"key":"e_1_2_14_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(21)00252-0"},{"key":"e_1_2_14_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60325-5"},{"key":"e_1_2_14_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD006876.pub5"},{"key":"e_1_2_14_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/1545968316666957"},{"key":"e_1_2_14_5_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000209495"},{"key":"e_1_2_14_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.wco.0000200544.29915.cc"},{"key":"e_1_2_14_7_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrn3112"},{"key":"e_1_2_14_8_2","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.3303-16.2017"},{"key":"e_1_2_14_9_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0180803"},{"key":"e_1_2_14_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/1743-0003-11-3"},{"key":"e_1_2_14_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/1743-0003-6-20"},{"key":"e_1_2_14_12_2","doi-asserted-by":"publisher","DOI":"10.3389\/frobt.2021.745018"},{"key":"e_1_2_14_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/1545968313498649"},{"key":"e_1_2_14_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10548-022-00915-y"},{"key":"e_1_2_14_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.109.577023"},{"key":"e_1_2_14_16_2","doi-asserted-by":"publisher","DOI":"10.1177\/15500594231209397"},{"key":"e_1_2_14_17_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_14_18_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898"},{"key":"e_1_2_14_19_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4919"},{"key":"e_1_2_14_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(86)90046-2"},{"key":"e_1_2_14_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13312-022-2500-y"},{"key":"e_1_2_14_22_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"key":"e_1_2_14_23_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l6890"},{"key":"e_1_2_14_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.04.026"},{"key":"e_1_2_14_25_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629"},{"key":"e_1_2_14_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2019.02.013"},{"key":"e_1_2_14_27_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12984-021-00867-7"},{"key":"e_1_2_14_28_2","doi-asserted-by":"publisher","DOI":"10.1109\/TNSRE.2024.3460485"},{"key":"e_1_2_14_29_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2018.00810"},{"key":"e_1_2_14_30_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12984-019-0563-3"},{"key":"e_1_2_14_31_2","doi-asserted-by":"publisher","DOI":"10.1155\/2021\/8866613"},{"key":"e_1_2_14_32_2","doi-asserted-by":"publisher","DOI":"10.1080\/10749357.2020.1803584"},{"key":"e_1_2_14_33_2","doi-asserted-by":"publisher","DOI":"10.3233\/RNN-180869"},{"key":"e_1_2_14_34_2","doi-asserted-by":"publisher","DOI":"10.1088\/1741-2552\/ac5757"},{"key":"e_1_2_14_35_2","doi-asserted-by":"publisher","DOI":"10.1109\/TNSRE.2015.2425474"},{"key":"e_1_2_14_36_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12984-021-00871-x"},{"key":"e_1_2_14_37_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2025.1579988"},{"key":"e_1_2_14_38_2","doi-asserted-by":"publisher","DOI":"10.1177\/1545968312445910"},{"key":"e_1_2_14_39_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2017.00452"},{"key":"e_1_2_14_40_2","doi-asserted-by":"publisher","DOI":"10.1177\/1545968318818902"},{"key":"e_1_2_14_41_2","doi-asserted-by":"publisher","DOI":"10.1310\/tsr2004-308"},{"key":"e_1_2_14_42_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.23879"},{"key":"e_1_2_14_43_2","doi-asserted-by":"publisher","DOI":"10.1109\/TNSRE.2020.3027955"},{"key":"e_1_2_14_44_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40001-023-01565-x"},{"key":"e_1_2_14_45_2","doi-asserted-by":"publisher","DOI":"10.3390\/brainsci11010056"},{"key":"e_1_2_14_46_2","doi-asserted-by":"publisher","DOI":"10.3233\/RNN-2009-0470"},{"key":"e_1_2_14_47_2","doi-asserted-by":"publisher","DOI":"10.3233\/NRE-130927"},{"key":"e_1_2_14_48_2","doi-asserted-by":"publisher","DOI":"10.1177\/1545968311402507"},{"key":"e_1_2_14_49_2","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/8105480"},{"key":"e_1_2_14_50_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2016.02.004"},{"key":"e_1_2_14_51_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12984-020-00792-1"},{"key":"e_1_2_14_52_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnhum.2023.1188806"},{"key":"e_1_2_14_53_2","doi-asserted-by":"publisher","DOI":"10.23736\/S1973-9087.23.07922-4"},{"key":"e_1_2_14_54_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnhum.2025.1671804"},{"key":"e_1_2_14_55_2","doi-asserted-by":"publisher","DOI":"10.3233\/NRE-230355"},{"key":"e_1_2_14_56_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2019.04.712"},{"key":"e_1_2_14_57_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2023.1116273"},{"key":"e_1_2_14_58_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2022.809657"},{"key":"e_1_2_14_59_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnhum.2025.1626000"},{"key":"e_1_2_14_60_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-16686-y"},{"key":"e_1_2_14_61_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awm311"},{"key":"e_1_2_14_62_2","doi-asserted-by":"publisher","DOI":"10.2174\/1874440002114010008"},{"key":"e_1_2_14_63_2","doi-asserted-by":"publisher","DOI":"10.3892\/etm.2025.12932"},{"key":"e_1_2_14_64_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2024.1411616"},{"key":"e_1_2_14_65_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0185936"},{"key":"e_1_2_14_66_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneng.2014.00030"},{"key":"e_1_2_14_67_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnhum.2021.656975"},{"key":"e_1_2_14_68_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2023.1241772"},{"key":"e_1_2_14_69_2","doi-asserted-by":"publisher","DOI":"10.3390\/biomimetics10020094"},{"key":"e_1_2_14_70_2","doi-asserted-by":"publisher","DOI":"10.1177\/1550059414522229"},{"key":"e_1_2_14_71_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2022.887205"},{"key":"e_1_2_14_72_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12984-025-01704-x"},{"key":"e_1_2_14_73_2","doi-asserted-by":"publisher","DOI":"10.1109\/TNSRE.2025.3616524"},{"key":"e_1_2_14_74_2","doi-asserted-by":"publisher","DOI":"10.19852\/j.cnki.jtcm.2025.04.015"},{"key":"e_1_2_14_75_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnhum.2020.611064"},{"key":"e_1_2_14_76_2","doi-asserted-by":"publisher","DOI":"10.1097\/MRR.0000000000000125"},{"key":"e_1_2_14_77_2","doi-asserted-by":"publisher","DOI":"10.12688\/f1000research.8603.1"},{"key":"e_1_2_14_78_2","doi-asserted-by":"publisher","DOI":"10.1109\/TNSRE.2017.2678161"},{"key":"e_1_2_14_79_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2023.1042254"},{"key":"e_1_2_14_80_2","first-page":"951","volume-title":"Converging Clinical and Engineering Research on Neurorehabilitation III. ICNR. 2018. Biosystems & Biorobotics","author":"Kinany N.","year":"2019"}],"container-title":["Neural Plasticity"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/np\/9282578","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/np\/9282578","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/np\/9282578","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T09:01:17Z","timestamp":1780650077000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/np\/9282578"}},"subtitle":[],"editor":[{"given":"Suraiya","family":"Saleem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":80,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/np\/9282578"],"URL":"https:\/\/doi.org\/10.1155\/np\/9282578","archive":["Portico"],"relation":{},"ISSN":["2090-5904","1687-5443"],"issn-type":[{"value":"2090-5904","type":"print"},{"value":"1687-5443","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2026-02-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"9282578"}}