ROBOTIC NEUROREHABILITATION IN NON-STROKE NEURAL INJURIES: A NARRATIVE REVIEW WITH ILLUSTRATIVE COHORT DATA

*Dr. Shashivadhanan, Dr. Rowa Mohamad Osman Mohmad Salih, Dr. Mitra Ghaznavijahromi, Dr. Seddigh Sadat Hosseini

ABSTRACT

Background: Robotic neurorehabilitation is an evolving treatment paradigm that leverages activity-dependent neuroplasticity to restore motor function after neural injury. While substantial evidence exists for its application in stroke, data on heterogeneous non-stroke neural injuries, including spinal cord injury (SCI), myelopathy, traumatic brain injury (TBI), and immune-mediated neuropathies remain limited. Objectives: This narrative review examines the current evidence for robotic rehabilitation across major non-stroke neural injury categories, evaluates relevant outcome measures, and presents illustrative cohort data from a tertiary rehabilitation centre in Oman to contextualise real-world applicability. Methods: A synthesis of published literature on robotic neurorehabilitation in SCI, myelopathy, TBI, and peripheral nerve injuries was conducted. Illustrative clinical data from 23 consecutive patients who underwent robotic rehabilitation were summarised using descriptive statistics and non-parametric within-group comparisons (Wilcoxon signed-rank test). Results: The reviewed literature consistently demonstrates improvements in motor function, gait velocity, and balance following robotic rehabilitation in non-stroke populations. In the illustrative cohort, 65% of patients showed at least one MRC grade improvement, 73% demonstrated improved balance scores, and 64% achieved faster gait on the 10-Metre Walk Test. Statistically significant gains were observed across all three domains (p < 0.05). Conclusion: Robotic neurorehabilitation produces meaningful functional gains across a spectrum of non-stroke neural injuries. Integration into multidisciplinary inpatient rehabilitation pathways is supported by both published evidence and real-world data. Prospective controlled trials with standardised protocols are needed to refine patient selection and dosing parameters.

Keywords: robotic rehabilitation; neurorehabilitation; spinal cord injury; myelopathy; traumatic brain injury; motor recovery; gait; balance; neuroplasticity.