The Effectiveness and Use of Digital Technology Interventions for Upper Limb Rehabilitation at Home in Acute and Subacute Stroke: A Systematic Review and Meta-Analysis

ObjectiveThis systematic review and meta-analysis aimed to evaluate the effectiveness of digital technology interventions for upper limb rehabilitation at home in the acute and subacute phases post-stroke. Data sourcesA multi-database search was conducted in Medline, EMBASE, PsycINFO, CINAHL, AMED, the Cochrane Library and Scopus up to 28th April 2025. Review methodsThis review was informed by Cochrane guidelines. Studies were grouped according to the nature of the digital technology in the intervention. Data was synthesised using narrative text, tabulation and where possible meta-analysis. Risk of bias and certainty of evidence were evaluated. The review was registered on PROSPERO (CRD420251027928). ResultsFrom 3498 records identified, twelve studies (787 participants) were included. Four groups of digital technology interventions were identified: virtual reality (n=7), electrical stimulation (n=2), wearable sensors (n=2), and mobile applications (n=1). Meta-analysis comparing virtual reality with time matched conventional exercise suggested no evidence of effect on either upper limb motor impairment (n=3, 241 participants, mean difference= - 0.23, 95% confidence interval (CI):-2.58 to 2.12) or activity limitation (n=5, 467 participants, standardised mean difference= 0.07, 95% CI:-0.25 to 0.38) with low certainty of evidence. ConclusionEvidence of the effectiveness of digital technology interventions for upper limb rehabilitation at home in the acute and subacute phases following stroke is limited. Further research is needed to understand if and how virtual reality interventions could provide an alternative therapy option. No summary conclusions could be drawn on the use of the other digital technologies identified in the review.