Use of myoelectric orthosis after stroke or traumatic brain injury: a systematic review

Upper extremity (UE) paralysis and weakness due to stroke or traumatic brain injury (TBI) can limit independent functioning. Myoelectrically controlled orthoses can be used for compensatory support for activities of daily living (ADL), and for restorative rehabilitation to reduce disability. We investigate the use of UE myoelectric orthoses (UE-MEO) for compensatory and/or restorative use after stroke or TBI. We conducted a systematic review (PROSPERO CRD42024577225) from 15 databases including MEDLINE®, Embase®, and APA PsycInfo®. Peer-reviewed reports from 2014 onwards with patient use of UE-MEO after stroke or TBI were included. Ten studies (11 reports) met the criteria; all included individuals post-stroke and one included a post-TBI subset. The majority were Oxford level of evidence 3b and rated as low risk of bias. All compensatory use studies showed participants could complete more activities or more parts of activities while wearing the UE-MEO. Studies in which the UE-MEO was studied as a restorative therapy took place in outpatient clinics and in the home setting, with mixed results across studies. The results suggest that use of a UE-MEO is a viable option as a compensatory tool to improve UE function in individuals with partial paralysis or weakness due to stroke or TBI. Additional evidence is needed to test the utility of a UE-MEO for restorative use and to identify the patient population most likely to derive benefits.