Efficacy of Robot-assisted Mirror Therapy in Post-stroke Motor Rehabilitation: A Systematic Review and Meta-analysis
Muaz Ahmed1, Hamid Bin Tariq2, Suleman Saeed2, Abdul Rehman3, Abdul Shahbaz4, Muhammad Ali Bhatti5, Anas Nasir6, Dania Hussain7, Muhammad Ali Bin Jabir8, Zahra Haque9, Izza Zahra8
1Akhtar Saeed Medical & Dental College, Lahore, Pakistan, 2University College of Medicine and Dentistry, Lahore, Pakistan, 3Services Institute of Medical Sciences, Lahore, Pakistan, 4Sialkot Medical College, Sialkot, Pakistan, 5Poonch Medical College Rawalakot, Rawalakot, AJK, Pakistan, 6Sheikh Zayed Medical College, Rahim Yar Khan, Pakistan, 7United Medical And Dental College, Karachi, Pakistan, 8Foundation University Medical College, Islamabad, Pakistan, 9Islamic International Medical College, Riphah International University, Rawalpindi, Pakistan
Objective:
To evaluate the effectiveness of Robotic Mirror Therapy compared to conventional rehabilitation in improving motor function among post-stroke adults.
Background:
Stroke often leads to motor dysfunction that limits functional independence, and conventional rehabilitation typically results in only partial recovery. Robot-Assisted Mirror Therapy (RMT), which integrates robotic-assisted movement with mirror visual feedback, has emerged as a promising approach to enhance neuroplasticity and improve motor function.
Design/Methods:
This systematic review and meta-analysis followed the PRISMA guidelines and was registered in PROSPERO (CRD420251167440). A comprehensive literature search was conducted in PubMed and Embase from inception to October 2025 to identify studies evaluating Robot-Assisted Mirror Therapy (RMT) for motor function recovery in post-stroke patients. Data were synthesized using random-effects models in RevMan, and pooled mean differences were calculated for pretest and posttest scores on the Fugl-Meyer Assessment (FMA) and Modified Ashworth Scale (MAS).
Results:
Eight studies involving 505 participants (293 intervention, 212 control) were included. Pooled analysis of the Fugl-Meyer Assessment (FMA-UE) showed a significant improvement in motor function with Robot-Assisted Mirror Therapy (RMT) compared to conventional rehabilitation (SMD = 0.50; 95% CI 0.11–0.89; p = 0.0113; I² = 58.4%). Baseline pretest values were comparable (SMD = 0.29; 95% CI 0.00–0.57; p = 0.0492; I² = 31.3%). For the Modified Ashworth Scale (MAS), no significant difference in post-intervention spasticity was found between groups (SMD = –0.05; 95% CI –0.26 to 0.15; p = 0.606; I² = 0.0%), confirming that RMT improves motor recovery but its effect on spasticity remains unclear.
Conclusions:
Robot-Assisted Mirror Therapy (RMT) significantly enhances upper-limb motor recovery in post-stroke patients but shows no clear benefit in reducing spasticity. These findings support incorporating robotic and visual feedback approaches into rehabilitation, though further large-scale trials are needed to confirm long-term effects.
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