Effects of MOTOmed movement therapy on the mobility and activities of daily living of stroke patients with hemiplegia: A systematic review and meta-analysis

Objective: To estimate the effectiveness of MOTOmed ^® movement therapy in increasing mobility and activities of daily living in stroke patients with hemiplegia. Design: Systematic review. Data sources: English- and Chinese-language articles published from the start of database coverage through 20 June 2018 were retrieved from the Embase, Web of Science, PubMed, OVID, Cochrane Central Register of Controlled Trials, Cochrane Systematic Reviews, Wanfang, Chinese National Knowledge Infrastructure, VIP, and Chinese Biomedicine databases. Articles were also retrieved by manual searches of Rehabilitation Medicine and Chinese journals. Methods: Randomized control trials examining MOTOmed movement therapy interventions for patients with post-stroke hemiplegia were included in this review. The risk of bias assessment tool was utilized in accordance with Cochrane Handbook 5.1.0. All included studies reported mobility effects as primary outcomes. Standardized mean differences or mean differences with the corresponding 95% confidence intervals (CIs) were calculated. Review Manager 5.3 was utilized for meta-analysis. Results: In total, 19 trials involving a total of 1099 patients were included in the analysis. All studies were of moderate quality, based on the Cochrane Handbook for Systematic Reviews of Intervention: Part 2:8.5. MOTOmed movement therapy resulted in a merged mean difference in the Fugl-Meyer Assessment score of 5.51 (95% CI: 4.03 to 6.98). Comparison of groups treated with and without MOTOmed movement therapy yielded the following mean differences: Modified Ashworth Scale, −1.13 (95% CI: −1.37 to −0.89); Berg Balance Scale, 13.66 (95% CI: 10.47–16.85); Functional Ambulation Category Scale, 0.85 (95% CI: 0.68–1.03); 10-m walk test, 10.15 (95% CI: 5.72–14.58); Barthel Index, 14.82 (95% CI: 12.96–16.68); and Modified Barthel Index, 11.49 (95% CI: 8.96–14.03). Conclusion: MOTOmed movement therapy combined with standard rehabilitation improves mobility and activities of daily living in stroke patients with hemiplegia.