Sex and gender differences in technology-based rehabilitation for people with stroke: A scoping review

Objectives This scoping review maps evidence on sex and gender differences in technology-assisted stroke rehabilitation and identifies gaps to inform equitable approaches. Data sources Searches were conducted in two rounds (up to March 2025 and April 2025–March 2026) on MEDLINE, CINAHL, Scopus, Web of Science, Cochrane Library, and Google Scholar. Review methods Following PRISMA-ScR guidelines, we included primary studies reporting sex and gender outcomes in adults with stroke receiving technological interventions, guided by the PCC framework. Results From 7071 records, 11 studies (1626 stroke survivors, 39.9% female) met inclusion criteria. Interventions included robotic exoskeletons, soft robotic gloves, virtual reality, exergaming, functional electrical stimulation, and biofeedback. Five studies found no significant sex differences. However, others reported female advantages in robotic gait training ( p = 0.007), functional electrical stimulation (OR = 3.92), soft robotic glove hand function (3.43-fold greater improvement), and Virtual Reality-based balance recovery ( p = 0.03). Younger women (<62 years) outperformed men in fine motor tasks, a pattern reversing with age. Conclusion Gender and sex disparities in rehabilitation outcomes vary by technology type, underscoring the need for inclusive device designs and improved female representation in trials. Future research must integrate biological and sociocultural perspectives and standardize outcome measures to optimize tailored rehabilitation for all stroke survivors.