Effectiveness of robotic therapy in the proximal and distal rehabilitation of the upper limb in patients after stroke using the Amadeo® and Armeo® devices: a systematic review of randomized clinical trials (Efectividad de la terapia robótica en la rehabilitación proximal y distal del miembro superior en personas tras un ictus con los dispositivos Amadeo® y Armeo®: una revisión sistemática de ensayos clínicos aleatorizados)

ABSTRACT

Based on the evidence published in the literature, we evaluated the effectiveness of the Amadeo® and Armeo® robotic devices used to treat patients who suffered a resulting functional deficit of the upper limbs after stroke. A systematic search was carried out by two independent reviewers in Pubmed, Cochrane Library, EBSCO, Otseeker, SciTePress, PEDro and Google Scholar databases following the PRISMA standard. Discrepancies between the two were resolved by consensus. Of the 799 articles initially identified, 13 RCTs were included for review as they met the inclusion criteria and showed highest methodological quality through a qualitative analysis of the evidence level according to PEDro and van Tulder scales. Relevant findings related to motor, cognitive and functional variables were analysed and discussed on a total of 595 stroke patients in different stages, based on their exposure to these devices. Strong evidence was found supporting rehabilitation of motor function and spasticity, moderate evidence for improvement in cognitive processes, limited evidence in improving pain and neuroplasticity and no evidence of changes in ADL or participation percentages. Robotic rehabilitation of the upper limb is effective after stroke.