Post-Stroke Technologies-Based Rehabilitation for the Upper Limb Recovery: A Systematic Review of Systematic Reviews (Preprint)

Abstract

Stroke is one of the most common cerebral vascular diseases, usually affecting people aged 60 and over, leading to a variety of disabilities requiring motor and cognitive rehabilitation. Post-stroke rehabilitation has a lead role in the recovery of the patients, and it is never too late to start. It should be implemented in a structured approach to help patients regain their physical, cognitive, and functional abilities. Technological solutions offer a beneficial and effective alternative to conventional therapy, making rehabilitation more accessible.

This study maps and synthesizes the evidence from published systematic reviews that assessed the effectiveness of technology-based rehabilitation for the recovery of the upper limb in post-stroke individuals.

Separate literature searches were conducted in PubMed, Web of Science, Scopus and Embase databases and Google Scholar. The PICOS was used to define inclusion criteria. There was no restriction on publication dates. The PRISMA flowchart was used in the retrieval and selection process. Then, the final articles were appraised for their methodological quality using the AMSTAR 2.

After the search process that identified 1450 records from the 4 databases and an additional 342 by Google Scholar, seven systematic reviews were included. The seven studies were published between 2019 and 2023.

This review indicated that the field of technology-based rehabilitation is still fragmented due to poor evidence of efficacy. This is probably due to the high heterogeneity of the experimental studies. When developing a technology-based rehabilitation program, it is crucial to carefully plan and link all relevant actors, user-driven design guidelines, and principles of neuroscience. There is a need for further research to understand better the impact of technology interventions on stroke deficits and recovery-related outcomes, both alone and in combination with traditional rehabilitation. This field of research could benefit from standardized rehabilitation protocols provided to patients, enabling comparison and interpretation to discover evidence currently missing.