Measurement Uncertainty and Traceability in Upper Limb Rehabilitation Robotics: A Metrology-Oriented Review

Upper-limb motor impairment is a major consequence of stroke and neuromuscular disorders, imposing a sustained clinical and socioeconomic burden worldwide. Quantitative assessment of limb positioning and motion accuracy is fundamental to rehabilitation, guiding therapy evaluation and robotic assistance. The evolution of upper-limb positioning systems has progressed from optical motion capture to wearable inertial measurement units (IMUs) and, more recently, to data-driven estimators integrated with rehabilitation robots. Each generation has aimed to balance spatial accuracy, portability, latency, and metrological reliability under ecological conditions. This review presents a systematic synthesis of the state of measurement uncertainty, calibration, and traceability in upper-limb rehabilitation robotics. Studies are categorised across four layers, i.e., sensing, fusion, cognitive, and metrological, according to their role in data acquisition, estimation, adaptation, and verification. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol was followed to ensure transparent identification, screening, and inclusion of relevant works. Comparative evaluation highlights how modern sensor-fusion and learning-based pipelines achieve near-optical angular accuracy while maintaining clinical usability. Persistent challenges include non-standard calibration procedures, magnetometer vulnerability, limited uncertainty propagation, and absence of unified traceability frameworks. The synthesis indicates a gradual transition toward cognitive and uncertainty-aware rehabilitation robotics in which metrology, artificial intelligence, and control co-evolve. Traceable measurement chains, explainable estimators, and energy-efficient embedded deployment emerge as essential prerequisites for regulatory and clinical translation. The review concludes that future upper-limb systems must integrate calibration transparency, quantified uncertainty, and interpretable learning to enable reproducible, patient-centred rehabilitation by 2030.