Rehabilitation methods for severe upper limb motor impairment in patients with chronic stroke

Introduction This scoping review aimed to identify and chart rehabilitation methods for severe upper limb motor impairments in patients with chronic stroke, incorporating both non-randomized controlled trials and randomized controlled trials (RCTs) to provide a broader perspective. Methods A search was conducted using PubMed and Web of Science. Data were managed using the Rayyan software. Two independent reviewers screened titles, abstracts, and full-text articles. Inclusion criteria included severe upper limb motor impairment, chronic stroke, RCTs, quasi-RCTs, and crossover studies. Results From 802 extracted articles, 16 met the inclusion criteria: 87.5% were RCTs, 12.5% were crossover trials, whereas 0% were quasi-RCTs. Major interventions included robot-assisted training (25%), noninvasive brain stimulation (25%), and electrical stimulation (31.3%). Although motor function improvements were frequently reported, few studies showed statistically significant differences compared with control groups. Discussion This review systematically mapped the range of study designs and rehabilitation methods identified in the literature, providing a structured overview of current evidence for severe upper limb motor impairments in patients with chronic stroke.