End-Effector-Based Robots for Post-Stroke Rehabilitation of Proximal Arm Joints: A Literature Review

Experiencing weakness or paralysis on one side of the body is a common consequence of stroke, with approximately 8 out of 10 patients experiencing some degree of Hemiparesis. Rehabilitation through physiotherapy and occupational therapy is one of the primary methods used to alleviate these conditions. However, physiotherapy, provided by a therapist, is not always readily available. Rehabilitation robots have been studied as alternatives and supplements to conventional therapy. These robots, based on their interaction with the user, can be categorized as end-effector and exoskeleton-based robots. This work aims to examine end-effector rehabilitation robots targeting hemiplegic arm’s proximal joints (shoulder and elbow) for post-stroke recovery. Additionally, we analyze their mechanical design, training modes, user interfaces, and clinical outcomes, highlighting trends and gaps in these systems. Furthermore, we suggest design considerations for home-based therapy and future integration with tele-rehabilitation, based on our findings. This review uniquely focuses on end-effector robots for proximal joints, synthesizing design trends and clinical evidence to guide future development.