# ROBOT-ASSISTED THERAPY FOLLOWING STROKE: WHAT EFFECTS ON QUALITY OF LIFE, COGNITIVE AND PSYCHOSOCIAL OUTCOMES? A SYSTEMATIC REVIEW

## TL;DR

Robot-assisted therapy after stroke may improve quality of life, cognition, and mood, but more research is needed to confirm long-term benefits.

## Contribution

This systematic review evaluates the non-motor effects of robot-assisted therapy following stroke, revealing its potential beyond motor recovery.

## Key findings

- Robot-assisted therapy improves emotional, physical, and social quality of life aspects.
- Cognitive domains like attention, memory, and language show significant improvements.
- Psychosocial outcomes such as anxiety and self-efficacy are positively impacted.

## Abstract

Robot-assisted therapy (RAT) has shown promise in post-stroke motor recovery. However, its effects on non-motor outcomes remain unclear. This systematic review evaluated RAT impact on post-stroke quality of life (QoL), cognition, and psychosocial functioning.

Following PRISMA guidelines, electronic searches were performed from Web of Science, PubMed, Cochrane Library, CINAHL, Embase, and PsycINFO. Risk of bias was assessed using NIH Quality Assessment Tools. Data on study design, participants, intervention characteristics, outcomes, and results were extracted and synthetized descriptively.

A total of 90 studies met the inclusion criteria. Considerable heterogeneity was found in participants’ characteristics, intervention duration (2–52 weeks), and dosage (20–240 min/session). Most studies reported significant RAT effects on QoL (emotional, physical, cognitive, social subdomains), cognition (attention, executive functions, memory, language, visuo-spatial abilities, intelligence), and psychosocial outcomes (anxiety, depression, self-efficacy, fear of falling, motivation, coping). Some studies also showed greater improvements compared with conventional training controls. Longitudinal effects were generally absent, except for QoL variations observed up to 12 months. Cognitive and psychological factors were also identified as moderators/predictors of RAT response.

Despite variability across studies, findings suggest RAT may have a broad impact beyond motor recovery. Future large-scale, standardized, longitudinal trials are recommended to confirm these results.

After a stroke, many people struggle not only with movement but also with thinking, emotions, and social life. Robot-assisted therapy is a new rehabilitation approach that helps patients perform repeated and precise movements with robotic support. We reviewed the studies of the last 2 decades to understand whether this therapy also improves aspects of life beyond movement. The results show that robot-assisted therapy can have positive effects on quality of life, mood, memory, attention, and well-being. Some studies even found better outcomes than with traditional rehabilitation. However, the improvements did not always last over time, and the studies differed in duration and intensity. Overall, our findings suggest that robot-assisted therapy could support more complete recovery after stroke, addressing both body and mind. Further research is still needed to confirm its long-term benefits for everyday clinical practice.