Evidence map›Paper›PMID 42246057›Full record

SynthesisNeural plasticity2026

Robot-Assisted Upper-Limb Rehabilitation After Stroke: A Systematic Review and Meta-Analysis of Cortical Reorganization and Neuroplasticity Biomarkers.

Rocco Salvatore Calabrò, Andrea Calderone, Lilla Bonanno, Angelo Quartarone, Antonino Naro, Alessandro Marco De Nunzio, Serena Filoni

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Neural plasticity, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Rocco Salvatore CalabròNeurorehabilitation Unit, IRCCS Bonino-Pulejo Center for Neurolesions, Messina, Italy.ORCID 0000-0002-8566-3166
Andrea CalderoneNeurorehabilitation Unit, IRCCS Bonino-Pulejo Center for Neurolesions, Messina, Italy.ORCID 0009-0006-5012-4425
Lilla BonannoNeurorehabilitation Unit, IRCCS Bonino-Pulejo Center for Neurolesions, Messina, Italy.
Angelo QuartaroneNeurorehabilitation Unit, IRCCS Bonino-Pulejo Center for Neurolesions, Messina, Italy.
Antonino NaroStroke Unit, University Hospital G. Martino, Messina, Italy.
Alessandro Marco De NunzioDepartment of Health, LUNEX University of Applied Sciences, Differdange, Luxembourg.
Serena FiloniNeurorehabilitation Unit, IRCCS House for the Relief of Suffering, San Giovanni Rotondo, Italy.

Funding

Current Research Funds 2026, Ministry of Health, Italy
6 · The paper itself

Abstract

backgroundRobot-assisted upper-limb rehabilitation is widely used after stroke, but links to neuroplasticity biomarkers remain uncertain.

objectiveTo synthesize biomarker evidence after robot-assisted upper-limb training and quantify post-intervention effects versus non-robot comparators.

methodsWe searched PubMed, Web of Science, Embase, Cochrane Library, EBSCOhost, and Scopus from inception to December 31, 2025. Randomized controlled trials (RCTs) and nonrandomized intervention studies enrolling adults with stroke were eligible if they reported at least one neuroplasticity biomarker. Prespecified comparison classes were used; only the primary contrast (robot-assisted training vs. non-robot control) was pooled at post using DerSimonian-Laird random-effects models. Effects were expressed as standardized mean differences (SMDs; Hedges' g) or mean differences (MDs) with 95% confidence intervals (CIs).

resultsFifty-five studies, including 24 RCTs, were included. Four RCTs contributed to the primary quantitative synthesis, and each pooled endpoint included two or three trials. Robot-assisted training was associated with improved ipsilesional resting motor threshold (RMT; SMD 1.77, 95% CI: 0.46-3.08; k = 2) and upper-limb impairment (Fugl-Meyer assessment-upper extremity [FMA-UE]; MD 4.48 points, 95% CI: 0.33-8.62; k = 3). Effects were uncertain for ipsilesional motor-evoked potential (MEP) amplitude (SMD 0.52, 95% CI: -0.31-1.34; k = 2) and activities of daily living (ADL). Heterogeneity was moderate to substantial, prediction intervals crossed the null, and certainty was low or very low.

conclusionsRobot-assisted training may improve impairment and corticospinal excitability, but randomized biomarker evidence remains sparse and heterogeneous. Biomarkers should be interpreted as exploratory observations, not validated surrogates or causal evidence of cortical restitution.

Indexed as

Neuronal PlasticityRoboticsStrokeStroke RehabilitationUpper ExtremityBiomarkersHumansTranscranial Magnetic StimulationBiomarkerscorticospinal excitabilitymotor-evoked potentialsrobot-assisted rehabilitationstroketranscranial magnetic stimulationupper extremity

Identifiers

PMID42246057
PMCPMC13238253

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.