Patients who receive electromechanical and robot-assisted arm training after stroke are more likely to improve their generic activities of daily living. Paretic arm function may also improve, but not arm muscle strength. However, the results must be interpreted with caution because there were variations between the trials in the duration and amount of training, type of treatment, and in the patient characteristics.

O ur results were not conclusive. We found that patients who receive electromechanical-assisted arm training after stroke are more likely to improve their generic activities of daily living and may improve arm function. The findings indicate, however, that motor strength of the paretic arm is not more likely to improve when patients after stroke train with electromechanical devices or robots. Because adverse events were rare, based on the data of 19 trials, these devices could be applied as a rehabilitation tool, but we still do not know when and how often they should be used.There is still a need for well-designed large-scale multicenter studies to evaluate benefits and harms of electromechanical-assisted arm training after stroke. Further research should address specific questions about the optimal type, timing, frequency, and duration of electromechanical and robot-assisted arm training.Background and Purpose-More than two thirds of all patients after stroke have difficulties with reduced arm function.Electromechanical and robot-assisted arm training devices are used in rehabilitation and might help to improve arm function after stroke. Our systematic review examined the effectiveness of electromechanical and robot-assisted arm training for improving generic activities of daily living, arm function, and arm muscle strength in patients after stroke and also assessed the acceptability and safety of the therapy.