Robot-assisted therapy for arm recovery for stroke patients: state of the art and clinical implication

Introduction: Robot-assisted therapy is an emerging approach that performs highly repetitive, intensive,
task oriented and quantifiable neuro-rehabilitation. In the last decades, it has been increasingly
used in a wide range of neurological central nervous system conditions implying an upper limb paresis.
Results from the studies are controversial, for the many types of robots and their features often not
accompanied by specific clinical indications about the target functions, fundamental for the individualized
neurorehabilitation program.
Areas covered: This article reviews the state of the art and perspectives of robotics in post-stroke
rehabilitation for upper limb recovery. Classifications and features of robots have been reported in
accordance with technological and clinical contents, together with the definition of determinants
specific for each patient, that could modify the efficacy of robotic treatments. The possibility of
combining robotic intervention with other therapies has also been discussed.
Expert commentary: The recent wide diffusion of robots in neurorehabilitation has generated
a confusion due to the commingling of technical and clinical aspects not previously clarified. Our
critical review provides a possible hypothesis about how to match a robot with subject’s upper limb
functional abilities, but also highlights the need of organizing a clinical consensus conference about the
robotic therapy.