Dose-response effects of robot-assisted training on poststroke functional recovery: A systematic review and meta-analysis

Robot-assisted training (RAT) is widely used in poststroke rehabilitation, but the relationship between training dose and functional recovery remains unclear. This review evaluated the effectiveness of RAT and examined dose-effect relationships.

PubMed, Web of Science, the Cochrane Library, and Embase were searched from inception to October 2025. Randomized controlled trials of adults with stroke comparing RAT or RAT combined with conventional rehabilitation (CR) were included. Study quality was assessed using the Cochrane risk-of-bias tool, and analyses were performed using Review Manager 5.4 and Stata 16.0. Pooled effects were expressed as mean differences (MDs) or standardized MDs with 95% confidence intervals (CIs). Exploratory subgroup analyses and random-effects meta-regression were conducted across 5 training-dose parameters, and restricted cubic spline analyses assessed nonlinear dose-effect relationships. Evidence certainty was evaluated using the Grading of Recommendations Assessment, Development and Evaluation. The review was registered with International Prospective Register of Systematic Reviews (CRD420251267710).