Summary of findings for the main comparison.
Electromechanical and robotic‐assisted training versus all other interventions for improving activities of daily living, arm function, and arm muscle strength after stroke
| Electromechanical and robotic‐assisted training versus all other interventions for improving activities of daily living, arm function, and arm muscle strength after stroke | |||||
| Patient or population: people after stroke Settings: rehabilitation facilities Intervention: electromechanical and robotic‐assisted training versus all other interventions | |||||
| Outcomes | Illustrative comparative risks* (95% CI) | No of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | ||||
| Control | Electromechanical and robotic‐assisted training versus all other interventions | ||||
| Activities of daily living at the end of intervention phase ‐ all studies Measures of activities. Scale from: 0 to inf | The mean activities of daily living at the end of intervention phase ‐ all studies in the control groups was NA | The mean activities of daily living at the end of intervention phase ‐ all studies in the intervention groups was 0.37 SDs higher (0.11 to 0.64 higher) | 717 (18 studies) | ⊕⊝⊝⊝ very low1,2,3 | SMD 0.37 (0.11 to 0.64) |
| Activities of daily living at the end of intervention phase: subgroup analysis comparing acute and chronic phase ‐ particpants treated in the acute and subacute phase of their stroke (within 3 months) Measures of activities. Scale from: 0 to inf | The mean activities of daily living at the end of intervention phase: subgroup analysis comparing acute and chronic phase ‐ participants treated in the acute and subacute phase of their stroke (within 3 months) in the control groups was NA | The mean activities of daily living at the end of intervention phase: subgroup analysis comparing acute and chronic phase ‐ participants treated in the acute and subacute phase of their stroke (within 3 month) in the intervention groups was 0.53 SDs higher (0.09 to 0.96 higher) | 320 (8 studies) | ⊕⊕⊝⊝ low2,3 | SMD 0.53 (0.09 to 0.96) |
| Activities of daily living at the end of intervention phase: subgroup analysis comparing acute and chronic phase ‐ participants treated in the chronic phase (more than 3 months) Measures of activities. Scale from: 0 to inf | The mean activities of daily living at the end of intervention phase: subgroup analysis comparing acute and chronic phase ‐ participants treated in the chronic phase (more than 3 months) in the control groups was NA | The mean activities of daily living at the end of intervention phase: subgroup analysis comparing acute and chronic phase ‐ participants treated in the chronic phase (more than 3 months) in the intervention groups was 0.66 SDs higher (‐0.17 lower to 1.49 higher) | 397 (10 studies) | ⊕⊕⊝⊝ low1,2,3 | SMD 0.66 (‐0.08 to 1.41) |
| Arm function at the end of intervention phase Measures of arm function. Scale from: 0 to inf | The mean arm function at the end of intervention phase in the control groups was NA | The mean arm function at the end of intervention phase in the intervention groups was 0.35 SDs higher (0.18 to 0.51 higher) | 1078 (31 studies) | ⊕⊕⊝⊝ low1,3 | SMD 0.35 (0.18 to 0.51) |
| Arm muscle strength at the end of intervention phase Measures of arm muscle strength. Scale from: 0 to inf | The mean arm muscle strength at the end of intervention phase in the control groups was NA | The mean arm muscle strength at the end of intervention phase in the intervention groups was 0.36 SDs higher (0.01 to 0.7 higher) | 568 (16 studies) | ⊕⊝⊝⊝ very low1,2,3 | SMD 0.36 (0.01 to 0.7) |
| Acceptability: dropouts during intervention period Rate of dropouts and adverse events | Study population | 1160 (34 studies) | ⊕⊕⊕⊝ moderate1 | Risks were calculated from pooled risk differences | |
| 42 per 1000 | 45 per 1000 (22 to 72) | ||||
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; NA: Not applicable; RR: Risk ratio; SD: Standard deviation; SMD: Standardised mean difference | |||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | |||||
1 Downgraded due to several ratings with 'high risk of bias'. 2 Downgraded due to considerable differences in effect sizes and unexplained heterogeneity. 3 Upper or lower confidence limit crosses an effect size of 0.5 in either direction.