Effects of robotic upper limb treatment after stroke on cognitive patterns: A systematic review

NeuroRehabilitation, 2022 · DOI: 10.3233/NRE-220149 · Published: January 1, 2022

Assistive Technology Neurology Neurorehabilitation

Simple Explanation

This review examines the impact of robotic therapy (RT) on cognitive functions in stroke patients undergoing upper limb rehabilitation. It investigates whether cognitive assessments are used as criteria for including or excluding patients and as measures of treatment outcomes. The review found that while cognitive measures are frequently used to determine who can participate in RT studies, they are rarely used to assess how RT affects cognitive abilities after stroke. The authors suggest that future research should focus on including cognitive assessments as outcome measures to better understand the relationship between motor and cognitive recovery in stroke rehabilitation with RT.

Study Duration

Not specified

Participants

3922 stroke patients

Evidence Level

Systematic Review of RCTs

Key Findings

1
Seventy-three out of eighty-one studies used cognitive instruments for inclusion/exclusion criteria.
2
Only seven studies assessed cognitive outcomes after robotic upper limb rehabilitation.
3
The Mini-Mental State Examination (MMSE) was the most frequently used cognitive screening tool, but the cutoff scores varied across studies.

Research Summary

This systematic review aimed to determine if cognitive measures are used as inclusion/exclusion criteria or outcome measures in robotic upper limb rehabilitation for stroke patients. The review of 81 studies found that cognitive measures are commonly used as inclusion/exclusion criteria, but rarely as outcome measures. The authors conclude that more research is needed to identify suitable cognitive scales and cut-offs for evaluating patients in different stroke stages and to assess cognitive outcomes of robotic rehabilitation.

Practical Implications

Clinical Practice

Encourages clinicians to consider cognitive assessments not only for patient selection but also to monitor cognitive changes during robotic upper limb rehabilitation.

Research

Highlights the need for future RCTs to include cognitive outcome measures to better understand the impact of robotic therapy on cognitive function after stroke.

Standardization

Suggests the development of guidelines for selecting appropriate cognitive scales and cut-offs for different stages of post-stroke rehabilitation.

Study Limitations

1
Heterogeneity in cognitive instruments used across studies.
2
Lack of standardized cut-off scores for cognitive inclusion/exclusion criteria.
3
Limited number of studies assessing cognitive outcomes of robotic rehabilitation.

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