Intensities in the application of robotic technologies in upper extremity rehabilitation after a stroke: a systematic review of randomised controlled clinical trials

Introduction. In the vast majority of cases stroke entails long-term limitations in the use of the upper extremities that are affected. Robotic technologies provide beneficial results in motor rehabilitation, but the optimal levels of intensity are not known. Aims. To review the scientific literature (over the last 10 years) on robotic therapies (intervention group) compared to conventional therapies (control group) in the chronic phase of stroke, and to study correlations between variables that characterise the interventions and intensity variables. Subjects and methods. A systematic review was conducted of randomised controlled clinical trials in PubMed, Web of Science, Cochrane Library and Google Scholar, with results assessed by the Fugl-Meyer Assessment-Upper Extremity Motor Score (mFMA-UE). The methodological quality was analysed using the Physiotherapy Evidence Database scale (PEDro). Results. Thirteen studies from evidence level I (92%, excellent) were selected. Positive correlations between minutes per week and improvements in mFMA-UE are observed in the control group and in the intervention group, with a higher level of significance for the latter. Negative correlations are observed between the number of months since the lesion and improvements in the control and intervention groups. An exponential regression is included, which illustrates differences between the control group and the intervention group in favour of the latter. A negative correlation is observed between the total duration and the number of minutes per week. Conclusion. Significant correlations are observed between intensity (minutes per week) and mFMA-UE, with a higher level of significance in the intervention group.