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Tivano Antoni, Benedictus Benedictus, Stefanus Erdana Putra | Brain Disorders | (2025)

Abstract

Introduction: Stroke is the primary contributor to disability worldwide, causing a high economic burden due to its morbidity. Due to the application of artificial intelligence (AI), stroke rehabilitation has been revolutionized, resulting in significant improvement. Implementing AI also enables home-based care, thus helping stroke patients who generally have ambulatory difficulties. Methods: This research was a systematic review from Pubmed, ScienceDirect, and ProQuest, including randomized controlled trials (RCT) published from 2009 to 2024. Meta-analysis included seven studies discussing the functional and motoric outcomes of AI-assisted stroke rehabilitation. Results: Six studies included post-stroke patients within 3 to 6 months after the stroke occurred. AI models used were varied, ranging from end-effector or exoskeleton robots to a combination of both and virtual reality (VR). Overall, the included studies had a low risk of bias. Standard mean differences (SMDs) of the Barthel Index and Motricity Index were 0.16 and 0.60. No significant difference between AI-assisted stroke rehabilitation and conventional stroke rehabilitation for both outcomes. Non-inferiority trials showed that the AI-assisted method was not inferior to the conventional method of stroke rehabilitation. Discussion: Considering its feasibility, personalization, and flexible rehabilitation program, AI-assisted was non-inferior to the conventional method. A comprehensive guideline is needed to facilitate its usage in clinical practice. Conclusion: AI-assisted stroke rehabilitation was not inferior to conventional stroke rehabilitation.

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Sample Definition And Size

The meta-analysis included seven randomized controlled trials (RCTs) of AI-assisted stroke rehabilitation. Six of these studies involved post-stroke patients within 3 to 6 months after stroke onset.

Study Type

Systematic review and meta-analysis of randomized controlled trials.

Conflicts Of Interest

No conflicts of interest were declared in the provided abstract.

Results Summary

The pooled standard mean differences (SMDs) were 0.16 for the Barthel Index and 0.60 for the Motricity Index. There were no statistically significant differences between AI-assisted and conventional stroke rehabilitation for either outcome. The trials demonstrated non-inferiority of AI-assisted rehabilitation compared to conventional methods.

Referenced In

🧠 AI in Rehabilitation: The Hype vs. The Reality

New umbrella review of 32 systematic reviews by Abdalla et al. (2026) —here's what actually works and what's just noise.

🔑 The One Clear Win

Post-stroke upper limb recovery is thus far, the only area with reproducible evidence. A major network meta-analysis (Zhu et al., 2023) spanning 101 publications found robotic training + VR improves activity-level outcomes.

But here's the catch, any gains on impairment and daily independence vanish when assessors are blinded and practice dose is matched (Antoni et al., 2025)

  • Low back pain: AI-assisted physiotherapy also show no significant advantage over usual care (Kapil et al., 2025)

This simply means that the AI 'advantage' in its current state would be better described as 'comparable but not better' than conventional therapy.

⚠️The Brutal Lab-to-Clinic Drop

In the real world, conditions are messy: different hospitals, different equipment, different patient populations - Causing the actual implementation of AI to see some setbacks.

  • Brain-computer interfaces: ~99% offline accuracy → ~50% online in actual patients (Gutierrez-Martinez et al., 2021).

  • Computer vision for movement tracking? Falls apart under real-world conditions (Sardari et al., 2023).

💡 The Bottom Line for AI in Rehabilitation

Only stroke imaging AI is deployment-ready today. Everything else? Can be used as capacity extenders, but not pure replacements.

The writers close off with a demand for newer AI papers to provide Proof of meaningful functional gains, external validation, and equity-by-design before any adoption.

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