Effectiveness of Neurorehabilitation Interventions on Functional Recovery After Stroke: A Meta-Analysis of Randomized Controlled Trials

Asmaa A. Al-kasassbeh; Ryan Maasarji; Sara A. Alkhamaiseh; Hana W. Mustafa; Yasmin Z. Alzubaidi; Hammam Bany-Yasin; Haitham AlZoubi; Abdallah Alqudah; Ghassan Bayat; Motaz M. Alfanek; Abdel Rahman Bani Yassin; Ahmad Alyousef; Ahmad H. Al-Quraan; Areen Fayez Al-Shoura

doi:10.63332/joph.v5i5.1976

Authors

Asmaa A. Al-kasassbeh Department of Physiotherapy, School of Allied Medical Sciences, Isra University, Amman, Jordan
Ryan Maasarji King Hussein Medical Center, Amman, Jordan
Sara A. Alkhamaiseh Department of Medicine, School of Medicine, Mutah University, Al-Karak, Jordan
Hana W. Mustafa Department of Physical Therapy, School of Allied Health Sciences, Al Isra University, Amman, Jordan
Yasmin Z. Alzubaidi Department of Physiotherapy, University of Jordan, Amman, Jordan
Hammam Bany-Yasin Department of Medicine, University Hospital of Plymouth NHS Trust, Plymouth, UK
Haitham AlZoubi Department of Surgery, University Hospital of Plymouth NHS Trust, Plymouth, UK
Abdallah Alqudah General Surgery, Gloucestershire Hospitals NHS Foundation Trust, UK
Ghassan Bayat Department of Medicine, University Hospital of Plymouth NHS Trust, Plymouth, UK
Motaz M. Alfanek Department of Medicine, School of Medicine, Yarmouk University, Irbid, Jordan
Abdel Rahman Bani Yassin School of Medicine, Jordan University of Science and Technology, Irbid, Jordan
Ahmad Alyousef Department of Neurology Medicine, Evangelisches Krankenhaus Dierdorf-Selters, Selters, Westerwald, Germany
Ahmad H. Al-Quraan Department of Medicine, University Hospital of Plymouth NHS Trust, Plymouth, UK
Areen Fayez Al-Shoura Department of maternal and child health, School of nursing, Zarqa University, Zarqa, Jordan

DOI:

https://doi.org/10.63332/joph.v5i5.1976

Keywords:

Neurorehabilitation, Stroke Recovery, Physiotherapy Exercise, Robot-Assisted Therapy, Repetitive Transcranial Magnetic Stimulation (Rtms), Virtual Reality (VR), Early Rehabilitation Nursing, Fugl-Meyer Assessment (FMA), Barthel Index, Exoskeleton.

Abstract

Neurorehabilitation is vital for restoring motor function and independence following stroke, yet the comparative effectiveness of various interventions remains uncertain. This meta-analysis synthesized data from 15 randomized controlled trials conducted between 2015 and 2025 to evaluate the impact of physiotherapy exercises, robot-assisted therapy, repetitive transcranial magnetic stimulation (rTMS), virtual reality (VR), and early rehabilitation nursing on functional recovery post-stroke. The analysis included 3,475 participants and assessed primary outcomes such as the Fugl–Meyer Assessment for upper extremity (FMA-UE), the Barthel Index for activities of daily living, and the Action Research Arm Test (ARAT). Results indicated that early rehabilitation nursing produced the greatest improvements in both motor recovery and functional independence (FMA-UE MD = 4.41, Barthel Index MD = 7.72), while robot-assisted therapy also showed significant, though more modest, gains in motor function (FMA-UE MD = 3.45). rTMS failed to demonstrate statistically significant benefits, and VR-based interventions yielded smaller yet positive effects, particularly in the subacute phase. Importantly, physiotherapy exercises—comprising aerobic conditioning, strength and flexibility training, task-specific practice, balance re-education, and neuromuscular retraining—were found to be consistently effective and enhanced the impact of other interventions when combined. Lower-limb robotic exoskeletons significantly improved balance and ambulation (e.g., Berg Balance Scale and 6-Minute Walk Test). Overall, the integration of structured physiotherapy exercises with early rehabilitation nursing or robotic interventions offers the most promising outcomes for stroke survivors, particularly when implemented early. These findings support a multimodal, patient-centered approach to post-stroke rehabilitation that leverages traditional physiotherapy alongside technological and nursing-based interventions for optimal recovery.