{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T01:36:44Z","timestamp":1792892204096,"version":"4.5.0"},"reference-count":102,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To systematically evaluate the efficacy of robotic-assisted therapy on upper extremity recovery after stroke through stratified meta-analysis, assessing the influence of disease phase, injury severity, device type, training parameters, and follow-up duration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a systematic literature search of PubMed, Embase, Cochrane Library, and Web of Science from inception to July 2025 for randomized controlled trials (RCTs) comparing robotic-assisted with conventional upper limb therapy in adult stroke patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Analysis of 42 RCTs (\n                      <jats:italic>n<\/jats:italic>\n                      =\u202f1,678) demonstrated that robotic-assisted therapy significantly improved motor function (Fugl-Meyer Upper Extremity Motor Assessment (FMA-UE)), grip strength (GS), activities of daily living (Modified Barthel Index (MBI)), and social participation (Stroke Impact Scale (SIS)) compared to conventional therapy. Crucially, patients in the subacute phase and those with severe impairment achieved clinically meaningful recovery, with improvements in motor function (FMA-UE: WMD\u202f=\u202f8.82, 95% CI (4.42, 13.23)) and activities of daily living (MBI: WMD\u202f=\u202f8.00, 95% CI (4.96, 11.03)) exceeding established Minimal Clinically Important Difference (MCID) thresholds.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Robotic-assisted therapy significantly improves upper extremity motor function and activities of daily living after stroke, with clinically meaningful gains particularly evident in subacute patients and those with severe impairment. Benefits in grip strength and social participation were statistically significant but of uncertain clinical importance due to methodological limitations. These findings support a stratified rehabilitation approach, prioritizing subacute and severely impaired patients for robotic intervention to maximize functional outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:uri>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD42025640276<\/jats:uri>\n                      , CRD42025640276.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2025.1640522","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T05:45:39Z","timestamp":1768196739000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Effects of robotic-assisted upper extremity therapy for stroke patients in different recovery phases: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"16","author":[{"given":"Lulu","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoling","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enyu","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cuiting","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1177\/17474930211065917","article-title":"World stroke organization (WSO): global stroke fact sheet 2022","volume":"17","author":"Feigin","year":"2022","journal-title":"Int J Stroke"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e209495","DOI":"10.1212\/WNL.0000000000209495","article-title":"Upper limb robots for recovery of motor arm function in patients with stroke: a systematic review and meta-analysis","volume":"103","author":"De Iaco","year":"2024","journal-title":"Neurology"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3310\/hta24540","article-title":"Robot-assisted training compared with an enhanced upper limb therapy programme and with usual care for upper limb functional limitation after stroke: the RATULS three-group RCT","volume":"24","author":"Rodgers","year":"2020","journal-title":"Health Technol Assess"},{"key":"ref4","first-page":"663","article-title":"Development of robots for rehabilitation therapy: the Palo Alto VA\/Stanford experience","volume":"37","author":"Burgar","year":"2000","journal-title":"J Rehabil Res Dev"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e01742","DOI":"10.1002\/brb3.1742","article-title":"Robot-assisted therapy for upper-limb rehabilitation in subacute stroke patients: a systematic review and meta-analysis","volume":"10","author":"Chien","year":"2020","journal-title":"Brain Behav"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1186\/s12984-020-00715-0","article-title":"Systematic review with network meta-analysis of randomized controlled trials of robotic-assisted arm training for improving activities of daily living and upper limb function after stroke","volume":"17","author":"Mehrholz","year":"2020","journal-title":"J Neuroeng Rehabil"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1111\/ane.13672","article-title":"Effects of robotic rehabilitation on recovery of hand functions in acute stroke: a preliminary randomized controlled study","volume":"146","author":"Coskunsu","year":"2022","journal-title":"Acta Neurol Scand"},{"key":"ref8","first-page":"511","article-title":"The MIME robotic system for upper-limb Neuro-rehabilitation: results from a clinical trial in subacute stroke","author":"Lum","year":"2005"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2024.1411616","article-title":"Effects of robot-assisted hand function therapy on brain functional mechanisms: a synchronized study using fNIRS and sEMG","volume":"11","author":"Cheng","year":"2024","journal-title":"Front Med"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"900","DOI":"10.3390\/brainsci13060900","article-title":"The application of soft robotic gloves in stroke patients: a systematic review and Meta-analysis of randomized controlled trials","volume":"13","author":"Ko","year":"2023","journal-title":"Brain Sci"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1186\/s42466-020-00060-6","article-title":"Recovery from stroke: current concepts and future perspectives","volume":"2","author":"Grefkes","year":"2020","journal-title":"Neurol Res Pract"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"384","DOI":"10.23736\/S1973-9087.19.05808-8","article-title":"How to use the international classification of functioning, disability and health as a reference system for comparative evaluation and standardized reporting of rehabilitation interventions","volume":"55","author":"Stucki","year":"2019","journal-title":"Eur J Phys Rehabil Med"},{"key":"ref13","doi-asserted-by":"crossref","DOI":"10.6028\/NIST.SP.1038","volume-title":"The international system of units (SI) - conversion factors for general use","author":"Butcher","year":"2006"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1616","DOI":"10.1109\/TNSRE.2024.3387320","article-title":"Socially assistive robot for stroke rehabilitation: a long-term in-the-wild pilot randomized controlled trial","volume":"32","author":"Feingold-Polak","year":"2024","journal-title":"IEEE Trans Neural Syst Rehabil Eng"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1005","DOI":"10.1177\/1545968317744276","article-title":"SMART arm training with outcome-triggered electrical stimulation in subacute stroke survivors with severe arm disability: a randomized controlled trial","volume":"31","author":"Barker","year":"2017","journal-title":"Neurorehabil Neural Repair"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1037","DOI":"10.1007\/s00415-014-7345-4","article-title":"Sequential combination of robot-assisted therapy and constraint-induced therapy in stroke rehabilitation: a randomized controlled trial","volume":"261","author":"Hsieh","year":"2014","journal-title":"J Neurol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1772","DOI":"10.1056\/NEJMoa0911341","article-title":"Robot-assisted therapy for long-term upper-limb impairment after stroke","volume":"362","author":"Lo","year":"2010","journal-title":"N Engl J Med"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"508","DOI":"10.3389\/fneur.2024.1453508","article-title":"Robot-assisted therapy in stratified intervention: a randomized controlled trial on poststroke motor recovery","volume":"15","author":"Liu","year":"2024","journal-title":"Front Neurol"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1041","DOI":"10.1016\/j.apmr.2024.01.027","article-title":"The combined effect of robot-assisted therapy and activities of daily living training on upper limb recovery in persons with subacute stroke: a randomized controlled trial","volume":"105","author":"Bhattacharjee","year":"2024","journal-title":"Arch Phys Med Rehabil"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1","DOI":"10.2340\/jrm.v54.882","article-title":"Comparative effectiveness of robot-assisted training versus enhanced upper extremity therapy on upper and lower extremity for stroke survivors: a multicentre randomized controlled trial","volume":"54","author":"Yingnan","year":"2022","journal-title":"J Rehabil Med"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"2074","DOI":"10.1016\/j.apmr.2021.06.001","article-title":"Exoskeleton-assisted anthropomorphic movement training (EAMT) for poststroke upper limb rehabilitation: a pilot randomized controlled trial","volume":"102","author":"Chen","year":"2021","journal-title":"Arch Phys Med Rehabil"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"7659893","DOI":"10.1155\/2017\/7659893","article-title":"ArmAssist robotic system versus matched conventional therapy for poststroke upper limb rehabilitation: a randomized clinical trial","volume":"2017","author":"Tomi\u0107","year":"2017","journal-title":"Biomed Res Int"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1177\/1545968313513073","article-title":"Randomized trial of a robotic assistive device for the upper extremity during early inpatient stroke rehabilitation","volume":"28","author":"Masiero","year":"2014","journal-title":"Neurorehabil Neural Repair"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1682\/JRRD.2010.04.0063","article-title":"Upper-limb robot-assisted therapy in rehabilitation of acute stroke patients: focused review and results of new randomized controlled trial","volume":"48","author":"Masiero","year":"2011","journal-title":"J Rehabil Res Dev"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"111445","DOI":"10.1016\/j.jocn.2025.111445","article-title":"The impact of robotic hand rehabilitation on hand function and fatigue in patients with stroke (RoHa-S)","volume":"139","author":"Castelli","year":"2025","journal-title":"J Clin Neurosci"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"767","DOI":"10.1016\/j.clinph.2019.02.013","article-title":"Does hand robotic rehabilitation improve motor function by rebalancing interhemispheric connectivity after chronic stroke? Encouraging data from a randomised-clinical-trial","volume":"130","author":"Calabr\u00f2","year":"2019","journal-title":"Clin Neurophysiol"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1177\/0269215516642606","article-title":"Feasibility and efficacy of a robotic device for hand rehabilitation in hemiplegic stroke patients: a randomized pilot controlled study","volume":"31","author":"Vanoglio","year":"2017","journal-title":"Clin Rehabil"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1186\/s12984-015-0033-5","article-title":"Efficacy of robot-assisted fingers training in chronic stroke survivors: a pilot randomized-controlled trial","volume":"12","author":"Susanto","year":"2015","journal-title":"J Neuroeng Rehabil"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"315125251347790","DOI":"10.1177\/00315125251347790","article-title":"The effects of robot-assisted therapy on upper extremity functions and functional independence in geriatric individuals with chronic stroke: a randomized controlled study","volume":"30","author":"Tekin","year":"2025","journal-title":"Percept Mot Skills"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1464","DOI":"10.1161\/STROKEAHA.122.041480","article-title":"Exoskeleton-assisted anthropomorphic movement training for the upper limb after stroke: the EAMT randomized trial","volume":"54","author":"Chen","year":"2023","journal-title":"Stroke"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"209","DOI":"10.3233\/NRE-203130","article-title":"Impact of smart force feedback rehabilitation robot training on upper limb motor function in the subacute stage of stroke","volume":"47","author":"Xu","year":"2020","journal-title":"NeuroRehabilitation"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1016\/j.jbmt.2019.03.016","article-title":"Upper limb robot-assisted rehabilitation versus physical therapy on subacute stroke patients: a follow-up study","volume":"24","author":"Franceschini","year":"2020","journal-title":"J Bodyw Mov Ther"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"659","DOI":"10.3233\/THC-181336","article-title":"Effects of robot-assisted therapy on upper extremity function and activities of daily living in hemiplegic patients: a single-blinded, randomized, controlled trial","volume":"26","author":"Lee","year":"2018","journal-title":"Technol Health Care"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1186\/1743-0003-11-104","article-title":"Effects of upper limb robot-assisted therapy on motor recovery in subacute stroke patients","volume":"11","author":"Sale","year":"2014","journal-title":"J Neuroeng Rehabil"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"1938","DOI":"10.1212\/WNL.54.10.1938","article-title":"A novel approach to stroke rehabilitation: robot-aided sensorimotor stimulation","volume":"54","author":"Volpe","year":"2000","journal-title":"Neurology"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1186\/s12984-024-01372-3","article-title":"Effect of task-oriented training assisted by force feedback hand rehabilitation robot on finger grasping function in stroke patients with hemiplegia: a randomised controlled trial","volume":"21","author":"Li","year":"2024","journal-title":"J Neuroeng Rehabil"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"7343","DOI":"10.3390\/jcm11247343","article-title":"A smart glove digital system promotes restoration of upper limb motor function and enhances cortical hemodynamic changes in subacute stroke patients with mild to moderate weakness: a randomized controlled trial","volume":"11","author":"Shin","year":"2022","journal-title":"J Clin Med"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1016\/j.rehab.2019.04.002","article-title":"Effectiveness of upper-limb robotic-assisted therapy in the early rehabilitation phase after stroke: a single-blind, randomised, controlled trial","volume":"62","author":"Dehem","year":"2019","journal-title":"Ann Phys Rehabil Med"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1177\/1558944717692096","article-title":"Efficacy of short-term robot-assisted rehabilitation in patients with hand paralysis after stroke: a randomized clinical trial","volume":"13","author":"Villafa\u00f1e","year":"2018","journal-title":"Hand"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1109\/TNSRE.2016.2569070","article-title":"Benefits of using a voice and EMG-driven actuated glove to support occupational therapy for stroke survivors","volume":"25","author":"Thielbar","year":"2017","journal-title":"IEEE Trans Neural Syst Rehabil Eng"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1097\/MRR.0000000000000059","article-title":"Recovery of hand function with robot-assisted therapy in acute stroke patients: a randomized-controlled trial","volume":"37","author":"Sale","year":"2014","journal-title":"Int J Rehabil Res"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"533","DOI":"10.3233\/THC-182500","article-title":"Effects of robot-assisted training on upper limb functional recovery during the rehabilitation of poststroke patients","volume":"26","author":"Daunoraviciene","year":"2018","journal-title":"Technol Health Care Off J Eur Soc Eng Med"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"539","DOI":"10.5535\/arm.2017.41.4.539","article-title":"Effect of robot-assisted game training on upper extremity function in stroke patients","volume":"41","author":"Lee","year":"2017","journal-title":"Ann Rehabil Med"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"254","DOI":"10.5606\/tftrd.2022.8705","article-title":"The effect of adding robot-assisted hand rehabilitation to conventional rehabilitation program following stroke: a randomized-controlled study","volume":"68","author":"Bay\u0131nd\u0131r","year":"2022","journal-title":"Turk J Phys Med Rehabil"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1016\/j.jht.2015.11.006","article-title":"Robot training for hand motor recovery in subacute stroke patients: a randomized controlled trial","volume":"29","author":"Orihuela-Espina","year":"2016","journal-title":"J Hand Ther"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"1487","DOI":"10.1109\/TNSRE.2024.3383857","article-title":"Continuous motion intention prediction using sEMG for upper-limb rehabilitation: a systematic review of model-based and model-free approaches","volume":"32","author":"Wei","year":"2024","journal-title":"IEEE Trans Neural Syst Rehabil Eng"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1186\/s12984-022-01058-8","article-title":"Short and long-term effects of robot-assisted therapy on upper limb motor function and activity of daily living in patients post-stroke: a meta-analysis of randomized controlled trials","volume":"19","author":"Zhang","year":"2022","journal-title":"J Neuroeng Rehabil"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1186\/s12984-020-00746-7","article-title":"Neurocognitive robot-assisted rehabilitation of hand function: a randomized control trial on motor recovery in subacute stroke","volume":"17","author":"Ranzani","year":"2020","journal-title":"J Neuroeng Rehabil"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"808","DOI":"10.3390\/jcm13030808","article-title":"Benefits of robot-assisted upper-limb rehabilitation from the subacute stage after a stroke of varying severity: a multicenter randomized controlled trial","volume":"13","author":"Ahn","year":"2024","journal-title":"J Clin Med"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1186\/1756-0500-5-52","article-title":"Meta-analyses and forest plots using a Microsoft excel spreadsheet: step-by-step guide focusing on descriptive data analysis","volume":"5","author":"Neyeloff","year":"2012","journal-title":"BMC Res Notes"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1177\/1545968308331148","article-title":"A randomized controlled trial of gravity-supported, computer-enhanced arm exercise for individuals with severe hemiparesis","volume":"23","author":"Housman","year":"2009","journal-title":"Neurorehabil Neural Repair"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"1177","DOI":"10.1007\/s10072-021-05431-8","article-title":"Evaluation of an upper limb robotic rehabilitation program on motor functions, quality of life, cognition, and emotional status in patients with stroke: a randomized controlled study","volume":"43","author":"Taravati","year":"2022","journal-title":"Neurol Sci"},{"key":"ref53","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1177\/17474930231156753","article-title":"A systematic review and synthesis of global stroke guidelines on behalf of the world stroke organization","volume":"18","author":"Mead","year":"2023","journal-title":"Int J Stroke"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"880","DOI":"10.1177\/23969873231191304","article-title":"Motor rehabilitation after stroke: european stroke organisation (ESO) consensus-based definition and guiding framework","volume":"8","author":"Kwakkel","year":"2023","journal-title":"Eur Stroke J"},{"key":"ref55","doi-asserted-by":"publisher","first-page":"249","DOI":"10.7326\/ANNALS-24-02205","article-title":"Stroke rehabilitation: synopsis of the 2024 U.S. department of veterans affairs and U.S. department of defense clinical practice guidelines","volume":"178","author":"Eapen","year":"2025","journal-title":"Ann Intern Med"},{"key":"ref56","doi-asserted-by":"publisher","first-page":"1150","DOI":"10.1177\/1545968320956648","article-title":"Gains across WHO dimensions of function after robot-based therapy in stroke subjects","volume":"34","author":"Wu","year":"2020","journal-title":"Neurorehabil Neural Repair"},{"key":"ref57","doi-asserted-by":"publisher","first-page":"791","DOI":"10.2522\/ptj.20110009","article-title":"Clinically important differences for the upper-extremity Fugl-Meyer scale in people with minimal to moderate impairment due to chronic stroke","volume":"92","author":"Page","year":"2012","journal-title":"Phys Ther"},{"key":"ref58","doi-asserted-by":"publisher","first-page":"1385","DOI":"10.1161\/STROKEAHA.115.012520","article-title":"Efficacy of upper extremity robotic therapy in subacute poststroke hemiplegia: an exploratory randomized trial","volume":"47","author":"Takahashi","year":"2016","journal-title":"Stroke"},{"key":"ref59","doi-asserted-by":"publisher","first-page":"1000074","DOI":"10.2340\/20030711-1000074","article-title":"Efficacy of electromechanically-assisted rehabilitation of upper limb function in post-stroke patients: a randomized controlled study","volume":"4","author":"Kim","year":"2021","journal-title":"J Rehabil Med Clin Commun"},{"key":"ref60","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1177\/1545968307303401","article-title":"Assessing mechanisms of recovery during robot-aided neurorehabilitation of the upper limb","volume":"22","author":"Colombo","year":"2008","journal-title":"Neurorehabil Neural Repair"},{"key":"ref61","doi-asserted-by":"publisher","first-page":"e2026676118","DOI":"10.1073\/pnas.2026676118","article-title":"Critical period after stroke study (CPASS): a phase II clinical trial testing an optimal time for motor recovery after stroke in humans","volume":"118","author":"Dromerick","year":"2021","journal-title":"Proc Natl Acad Sci"},{"key":"ref62","doi-asserted-by":"publisher","first-page":"486","DOI":"10.1177\/1545968309356295","article-title":"Minimal detectable change and clinically important difference of the stroke impact scale in stroke patients","volume":"24","author":"Lin","year":"2010","journal-title":"Neurorehabil Neural Repair"},{"key":"ref63","doi-asserted-by":"publisher","first-page":"5975422","DOI":"10.1109\/ICORR.2011.5975422","article-title":"Robot-aided therapy on the upper limb of subacute and chronic stroke patients: a biomechanical approach","volume":"2011","author":"Mazzoleni","year":"2011","journal-title":"IEEE Int Conf Rehabil Robot Proc"},{"key":"ref64","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1186\/s12984-021-00867-7","article-title":"Evidence of neuroplasticity with robotic hand exoskeleton for post-stroke rehabilitation: a randomized controlled trial","volume":"18","author":"Singh","year":"2021","journal-title":"J Neuroeng Rehabil"},{"key":"ref65","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1186\/s12984-022-00986-9","article-title":"Impact of the robotic-assistance level on upper extremity function in stroke patients receiving adjunct robotic rehabilitation: sub-analysis of a randomized clinical trial","volume":"19","author":"Takebayashi","year":"2022","journal-title":"J Neuroeng Rehabil"},{"key":"ref66","doi-asserted-by":"publisher","first-page":"5323","DOI":"10.1038\/s41598-021-84536-8","article-title":"A randomized controlled trial on the effects induced by robot-assisted and usual-care rehabilitation on upper limb muscle synergies in post-stroke subjects","volume":"11","author":"Lencioni","year":"2021","journal-title":"Sci Rep"},{"key":"ref67","doi-asserted-by":"publisher","first-page":"e26","DOI":"10.1097\/PHM.0b013e3182a1e852","article-title":"Upper limb robot-assisted therapy in chronic and subacute stroke patients: a kinematic analysis","volume":"92","author":"Mazzoleni","year":"2013","journal-title":"Am J Phys Med Rehabil"},{"key":"ref68","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1186\/s12984-020-00792-1","article-title":"Behavioral and neurophysiological effects of an intensified robot-assisted therapy in subacute stroke: a case control study","volume":"18","author":"Sehle","year":"2021","journal-title":"J Neuroeng Rehabil"},{"key":"ref69","doi-asserted-by":"publisher","first-page":"pzad002","DOI":"10.1093\/ptj\/pzad002","article-title":"Efficacy and dose of rehabilitation approaches for severe upper limb impairments and disability during early acute and subacute stroke: a systematic review","volume":"103","author":"Doumen","year":"2023","journal-title":"Phys Ther"},{"key":"ref70","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1038\/s41583-020-00396-7","article-title":"Encouraging an excitable brain state: mechanisms of brain repair in stroke","volume":"22","author":"Joy","year":"2021","journal-title":"Nat Rev Neurosci"},{"key":"ref71","doi-asserted-by":"publisher","first-page":"444","DOI":"10.1177\/1747493017711816","article-title":"Agreed definitions and a shared vision for new standards in stroke recovery research: the stroke recovery and rehabilitation roundtable taskforce","volume":"12","author":"Bernhardt","year":"2017","journal-title":"Int J Stroke"},{"key":"ref72","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1097\/MRR.0000000000000204","article-title":"Robotic approaches for the rehabilitation of upper limb recovery after stroke: a systematic review and meta-analysis","volume":"40","author":"Zhang","year":"2017","journal-title":"Int J Rehabil Res"},{"key":"ref73","doi-asserted-by":"publisher","first-page":"pzab010","DOI":"10.1093\/ptj\/pzab010","article-title":"Robot-assisted therapy for upper extremity motor impairment after stroke: a systematic review and Meta-analysis","volume":"101","author":"Wu","year":"2021","journal-title":"Phys Ther"},{"key":"ref74","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1016\/S1474-4422(13)70305-3","article-title":"Three-dimensional, task-specific robot therapy of the arm after stroke: a multicentre, parallel-group randomised trial","volume":"13","author":"Klamroth-Marganska","year":"2014","journal-title":"Lancet Neurol"},{"key":"ref75","doi-asserted-by":"publisher","first-page":"700","DOI":"10.3390\/brainsci13040700","article-title":"Neurophysiological and clinical effects of upper limb robot-assisted rehabilitation on motor recovery in patients with subacute stroke: a multicenter randomized controlled trial study protocol","volume":"13","author":"Pournajaf","year":"2023","journal-title":"Brain Sci"},{"key":"ref76","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1080\/10749357.2021.1967657","article-title":"Exoskeleton versus end-effector robot-assisted therapy for finger-hand motor recovery in stroke survivors: systematic review and meta-analysis","volume":"29","author":"Moggio","year":"2022","journal-title":"Top Stroke Rehabil"},{"key":"ref77","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1177\/1545968316666957","article-title":"Effects of robot-assisted therapy for the upper limb after stroke: a systematic review and Meta-analysis","volume":"31","author":"Veerbeek","year":"2017","journal-title":"Neurorehabil Neural Repair"},{"key":"ref78","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1002\/kjm2.12679","article-title":"Robotic arm use for upper limb rehabilitation after stroke: a systematic review and meta-analysis","volume":"39","author":"Lee","year":"2023","journal-title":"Kaohsiung J Med Sci"},{"key":"ref79","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1177\/1545968315608448","article-title":"Long-term effectiveness of intensive therapy in chronic stroke","volume":"30","author":"Wu","year":"2016","journal-title":"Neurorehabil Neural Repair"},{"key":"ref80","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1016\/j.bbr.2016.08.029","article-title":"Factors affecting post-stroke motor recovery: implications on neurotherapy after brain injury","volume":"340","author":"Alawieh","year":"2018","journal-title":"Behav Brain Res"},{"key":"ref81","doi-asserted-by":"publisher","first-page":"2091","DOI":"10.1038\/s41598-018-20330-3","article-title":"Comparison of proximal versus distal upper-limb robotic rehabilitation on motor performance after stroke: a cluster controlled trial","volume":"8","author":"Hsieh","year":"2018","journal-title":"Sci Rep"},{"key":"ref82","doi-asserted-by":"publisher","first-page":"1641","DOI":"10.1007\/s10072-022-05913-3","article-title":"Robot-assisted distal training improves upper limb dexterity and function after stroke: a systematic review and meta-regression","volume":"43","author":"Zhao","year":"2022","journal-title":"Neurol Sci"},{"key":"ref83","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1186\/1743-0003-8-63","article-title":"Effects of a robot-assisted training of grasp and pronation\/supination in chronic stroke: a pilot study","volume":"8","author":"Lambercy","year":"2011","journal-title":"J Neuroeng Rehabil"},{"key":"ref84","doi-asserted-by":"publisher","first-page":"1498","DOI":"10.1016\/j.apmr.2023.02.004","article-title":"Efficacy of robot-assisted training on rehabilitation of upper limb function in patients with stroke: a systematic review and Meta-analysis","volume":"104","author":"Yang","year":"2023","journal-title":"Arch Phys Med Rehabil"},{"key":"ref85","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1016\/j.apmr.2006.10.032","article-title":"Robotic-assisted rehabilitation of the upper limb after acute stroke","volume":"88","author":"Masiero","year":"2007","journal-title":"Arch Phys Med Rehabil"},{"key":"ref86","doi-asserted-by":"publisher","first-page":"560","DOI":"10.1109\/TNSRE.2007.908560","article-title":"Design, implementation and clinical tests of a wire-based robot for neurorehabilitation","volume":"15","author":"Rosati","year":"2007","journal-title":"IEEE Trans Neural Syst Rehabil Eng"},{"key":"ref87","doi-asserted-by":"publisher","first-page":"607","DOI":"10.2340\/16501977-2361","article-title":"Effects of newly developed compact robot-aided upper extremity training systems (NEURO-x\u00ae) in patients with stroke: a pilot study","volume":"50","author":"Kim","year":"2018","journal-title":"J Rehabil Med"},{"key":"ref88","doi-asserted-by":"publisher","first-page":"1561","DOI":"10.1007\/s10072-017-2995-5","article-title":"Effects of robot-assisted upper limb rehabilitation in stroke patients: a systematic review with meta-analysis","volume":"38","author":"Bertani","year":"2017","journal-title":"Neurol Sci"},{"key":"ref89","doi-asserted-by":"publisher","first-page":"295","DOI":"10.3233\/THC-202127","article-title":"Effects of short-term upper limb robot-assisted therapy on the rehabilitation of sub-acute stroke patients","volume":"29","author":"Jiang","year":"2021","journal-title":"Technol Health Care"},{"key":"ref90","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1016\/j.pmr.2018.04.005","article-title":"Muscle overactivity in the upper motor neuron syndrome","volume":"29","author":"Segal","year":"2018","journal-title":"Phys Med Rehabil Clin N Am"},{"key":"ref91","doi-asserted-by":"publisher","first-page":"184","DOI":"10.3389\/fneur.2013.00184","article-title":"Neurophysiology of robot-mediated training and therapy: a perspective for future use in clinical populations","volume":"4","author":"Turner","year":"2013","journal-title":"Front Neurol"},{"key":"ref92","doi-asserted-by":"publisher","first-page":"105812","DOI":"10.1016\/j.jstrokecerebrovasdis.2021.105812","article-title":"Effects of a soft robotic hand for hand rehabilitation in chronic stroke survivors","volume":"30","author":"Shi","year":"2021","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"ref93","doi-asserted-by":"publisher","first-page":"926130","DOI":"10.3389\/fneur.2022.926130","article-title":"The predictive role of hand section of fugl\u2013meyer assessment and motor activity log in action research arm test in people with stroke","volume":"13","author":"Chen","year":"2022","journal-title":"Front Neurol"},{"key":"ref94","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1186\/s12984-022-00991-y","article-title":"A randomized clinical control study on the efficacy of three-dimensional upper limb robotic exoskeleton training in chronic stroke","volume":"19","author":"Frisoli","year":"2022","journal-title":"J Neuroeng Rehabil"},{"key":"ref95","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1177\/15459683241257519","article-title":"Task-oriented training by a personalized electromyography-driven soft robotic hand in chronic stroke: a randomized controlled trial","volume":"38","author":"Shi","year":"2024","journal-title":"Neurorehabil Neural Repair"},{"key":"ref96","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1186\/s12984-020-0646-1","article-title":"Effects of robot therapy on upper body kinematics and arm function in persons post stroke: a pilot randomized controlled trial","volume":"17","author":"Carpinella","year":"2020","journal-title":"J Neuroeng Rehabil"},{"key":"ref97","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1109\/TNSRE.2023.3339756","article-title":"Uncovering the neural mechanisms of inter-hemispheric balance restoration in chronic stroke through EMG-driven robot hand training: insights from dynamic causal Modeling","volume":"32","author":"Ti","year":"2024","journal-title":"IEEE Trans Neural Syst Rehabil Eng"},{"key":"ref98","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1186\/s12984-019-0513-0","article-title":"Boosting robot-assisted rehabilitation of stroke hemiparesis by individualized selection of upper limb movements - a pilot study","volume":"16","author":"Rosenthal","year":"2019","journal-title":"J Neuroeng Rehabil"},{"key":"ref99","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2024.06.009","article-title":"The combined effect of robot-assisted therapy and activities of daily living training on upper limb recovery in persons with subacute stroke: a randomized controlled trial","author":"Asirvatham","year":"2024","journal-title":"Arch Phys Med Rehabil"},{"key":"ref100","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1177\/1545968307311102","article-title":"Intensive sensorimotor arm training mediated by therapist or robot improves hemiparesis in patients with chronic stroke","volume":"22","author":"Volpe","year":"2008","journal-title":"Neurorehabil Neural Repair"},{"key":"ref101","doi-asserted-by":"publisher","first-page":"952","DOI":"10.1053\/apmr.2001.33101","article-title":"Robot-assisted movement training compared with conventional therapy techniques for the rehabilitation of upper-limb motor function after stroke","volume":"83","author":"Lum","year":"2002","journal-title":"Arch Phys Med Rehabil"},{"key":"ref102","doi-asserted-by":"publisher","first-page":"7078","DOI":"10.1080\/09638288.2021.1980915","article-title":"A tenodesis-induced-grip exoskeleton robot (TIGER) for assisting upper extremity functions in stroke patients: a randomized control study","volume":"44","author":"Hsu","year":"2022","journal-title":"Disabil Rehabil"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1640522\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T05:45:42Z","timestamp":1768196742000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1640522\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,12]]},"references-count":102,"alternative-id":["10.3389\/fneur.2025.1640522"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2025.1640522","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,12]]},"article-number":"1640522"}}