Conventional vs. robotic-assisted therapy in stroke rehabilitation: A systematic review of efficacy, functional outcomes, and patient adherence

Abstract

Background: Stroke remains a leading cause of adult disability worldwide, with motor dysfunction and reduced functional independence being prominent challenges in post-stroke recovery. Rehabilitation strategies have traditionally relied on conventional physiotherapy, but in recent years, robotic-assisted therapy has emerged as a promising alternative or adjunct. This systematic review aims to compare the efficacy, functional outcomes, and patient adherence between conventional and robotic-assisted therapy in stroke rehabilitation.Methods: A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and Google Scholar up to April 2025. Studies comparing conventional therapy with robotic-assisted interventions in post-stroke patients were included. Primary outcomes were motor recovery, functional independence, and adherence. Data were extracted and synthesized qualitatively, adhering to PRISMA guidelines.Results: Out of 1,236 identified records, 23 studies met the inclusion criteria. Both conventional and robotic-assisted therapies demonstrated significant improvements in motor function and activities of daily living (ADLs). Robotic-assisted therapy showed greater benefits in patients with moderate to severe impairments, particularly in the subacute phase. Furthermore, robotic interventions were associated with higher levels of patient engagement and adherence, attributed to interactive features and real-time feedback. However, long-term functional outcomes were similar across both modalities. Accessibility, cost, and therapist involvement remained key considerations in therapy selection.Conclusion: Robotic-assisted therapy offers an effective and engaging approach to stroke rehabilitation, especially when integrated with conventional methods. While both modalities are beneficial, the choice should be individualized based on stroke severity, phase of recovery, and patient preferences. Hybrid models combining the strengths of both approaches may represent the optimal rehabilitation strategy.