Strategies for Exoskeletal Upper Limb Robot with Bio-Sensors in Stroke Rehabilitation: A Scoping Review.

Background

Upper extremity motor impairment is common after stroke. The Hybrid Assistive Limb single-joint type (HAL-SJ), an exoskeletal robot with biosensors, assists voluntary movement by detecting biopotential signals. While there are reports of positive effects, optimal strategies and patient selection criteria remain unclear.

Objective

To map the evidence on HAL-SJ use for upper extremity recovery after stroke.

Methods

A scoping review was conducted using five databases (search date: September 20, 2025). The studies included stroke patients treated with HAL-SJ and reported motor function outcomes. Reviews, abstracts, and commentaries were excluded.

Results

Eight studies met the inclusion criteria. HAL-SJ improved upper limb motor function across recovery phases, with several studies reporting clinically meaningful improvements assessed by measures such as the Fugl-Meyer Assessment and Action Research Arm Test. Effective strategies included combining HAL-SJ with therapies such as botulinum toxin A and occupational therapy, and high-frequency training. Patients with moderate impairment benefited most; early intervention showed potential in severe cases.

Conclusion

HAL-SJ shows potential as a rehabilitation tool for stroke-related upper extremity motor impairment. However, all included studies were conducted in Japan, which may limit the generalizability of these findings. Large-scale, multicenter studies are needed to establish optimal intervention protocols.