Novel robotic rehabilitation in Bangladesh: A narrative review
DOI:
https://doi.org/10.3329/bsmmuj.v18i4.85196Keywords:
robotic rehabilitation, neurorehabilitation, Bangladesh, stroke, spinal cord injury, LMICsAbstract
Robotic rehabilitation has emerged as a transformative innovation in physical medicine, enabling high-intensity, task-specific, and measurable therapy that enhances neuroplasticity and functional recovery. This review summarises global evidence on robotic rehabilitation and examines its relevance and implementation challenges in low- and middle-income countries (LMICs), with a particular focus on the pioneering experience of the Bangladesh Medical University.
Methods: This narrative review synthesised literature from PubMed, Scopus, Web of Science, and Google Scholar published between January 2010 and September 2025. Included sources comprised reviews, meta-analyses, randomised controlled trials, observational studies, and policy documents addressing effectiveness, implementation, workforce, and health-system integration of robotic rehabilitation in LMICs. Evidence was thematically synthesised, prioritising higher-level studies, without formal PRISMA procedures or structured risk-of-bias assessment, consistent with accepted narrative review methodology.
Results: Global evidence supports robotic rehabilitation, with strongest benefits in stroke, moderate evidence in spinal cord injury, and emerging data in traumatic brain injury, neurodegenerative, paediatric, and musculoskeletal conditions. Effectiveness improves when robotics complement conventional therapy. In LMICs, adoption is hindered by financial, infrastructural, and workforce limitations. Bangladesh faces high disability burden and service gaps; the BMU Robotic Rehabilitation Centre represents a significant advancement in equitable, technology-driven rehabilitation.
Conclusion: Robotic rehabilitation offers measurable improvements in function and independence across diverse conditions. Strengthening infrastructure, workforce capacity, and policy support is essential for sustainable adoption in LMICs. The Bangladesh Medical University model demonstrates a feasible pathway for integrating advanced rehabilitation technologies in resource-constrained settings.
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References
Morone G, Paolucci S, Cherubini A, De Angelis D, Venturiero V, Coiro P, Iosa M. Robot-assisted gait training for stroke patients: current state of the art and perspectives of robotics. Neuropsychiatr Dis Treat. 2017 May 15;13:1303-1311. doi: https://doi.org/10.2147/NDT.S114102
Mehrholz J, Pohl M, Platz T, Kugler J, Elsner B. Electromechanical and robot-assisted arm training for improving activities of daily living, arm function, and arm muscle strength after stroke. Cochrane Database Syst Rev. 2018;9:CD006876. doi: https://doi.org/10.1002/14651858.CD006876.pub5
Calabrò RS, Sorrentino G, Cassio A, Mazzoli D, Andrenelli E, Bizzarini E, Campanini I, Carmignano SM, Cerulli S, Chisari C, Colombo V, Dalise S, Fundarò C, Gazzotti V, Mazzoleni D, Mazzucchelli M, Melegari C, Merlo A, Stampacchia G, Boldrini P, Mazzoleni S, Posteraro F, Benanti P, Castelli E, Draicchio F, Falabella V, Galeri S, Gimigliano F, Grigioni M, Mazzon S, Molteni F, Morone G, Petrarca M, Picelli A, Senatore M, Turchetti G, Bonaiuti D; Italian Consensus Conference on Robotics in Neurorehabilitation (CICERONE). Robotic-assisted gait rehabilitation following stroke: a systematic review of current guidelines and practical clinical recommendations. Eur J Phys Rehabil Med. 2021 Jun;57(3):460-471. doi: https://doi.org/10.23736/S1973-9087.21.06887-8
World Health Organization. World report on disability. Geneva: WHO; 2011. Available at: URL: https://www.who.int/publications/i/item/9789241564182. [Accessed on 15 Dec 2025]
Veerbeek JM, Langbroek-Amersfoort AC, Van Wegen EE, Meskers CG, Kwakkel G. Effects of robot-assisted therapy for the upper limb after stroke: a systematic review and meta-analysis. Neurorehabil Neural Repair. 2017;31(2):107–21. doi: https://doi.org/10.1177/1545968316666957
Molteni F, Gasperini G, Cannaviello G, Guanziroli E. Exoskeleton and end-effector robots for upper and lower limbs rehabilitation: narrative review. PM R. 2018;10(9 Suppl 2): S174–88. doi: https://doi.org/10.1016/j.pmrj.2018.06.005
Lo AC, Guarino PD, Richards LG, Haselkorn JK, Wittenberg GF, Federman DG, Ringer RJ, Wagner TH, Krebs HI, Volpe BT, Bever CT Jr, Bravata DM, Duncan PW, Corn BH, Maffucci AD, Nadeau SE, Conroy SS, Powell JM, Huang GD, Peduzzi P. Robot-assisted therapy for long-term upper-limb impairment after stroke. N Engl J Med. 2010 May 13;362(19):1772-83. doi: https://doi.org/10.1056/NEJMoa0911341
Bertani R, Melegari C, De Cola MC, Bramanti A, Bramanti P, Calabrò RS. Effects of robot-assisted upper limb rehabilitation in stroke patients: a systematic review with meta-analysis. Neurol Sci. 2017;38(9):1561–9. doi: https://doi.org/10.1007/s10072-017-2995-5
Sale P, Franceschini M, Waldner A, Hesse S. Use of the robot-assisted gait therapy in rehabilitation of patients with stroke and spinal cord injury. Eur J Phys Rehabil Med. 2012;48(1):111–21. PMID: 22543557
Miller LE, Zimmermann AK, Herbert WG. Clinical effectiveness and safety of powered exoskeleton-assisted walking in patients with spinal cord injury: systematic review with meta-analysis. Med Devices (Auckl). 2016 Mar 22;9:455-66. doi: https://doi.org/10.2147/MDER.S103102
Beretta E, Romei M, Molteni E, Avantaggiato P, Strazzer S. Combined robotic-aided gait training and physical therapy improve functional abilities and hip kinematics during gait in children and adolescents with acquired brain injury. Brain injury. 2015 Jul 3;29(7-8):955-62. doi: https://doi.org/10.3109/02699052.2015.1005130
MEDICA EM. Effects of robot-assisted gait training on postural instability in Parkinson’s disease: A systematic review. European journal of physical and rehabilitation medicine. 2021 Apr 7. doi: 10.23736/S1973-9087.21.06939-2
Calabrò RS, Russo M, Naro A, De Luca R, Leo A, Tomasello P, Molonia F, Dattola V, Bramanti A, Bramanti P. Robotic gait training in multiple sclerosis rehabilitation: Can virtual reality make the difference? Findings from a randomized controlled trial. J Neurol Sci. 2017 Jun 15;377:25-30. doi: https://doi.org/10.1016/j.jns.2017.03.047Uddin T, Islam MT, Hossain M, Hossain MS, Salek AK, Islam MJ, Haque S, Rahim HR, Hossain MS, Hassanuzzaman M, Islam M. Demographic and Clinical Characteristics of Persons With Spinal Cord Injury in Bangladesh: Database for the International Spinal Cord Injury Community Survey 2023. Neurotrauma Reports. 2023 Sep 1;4(1):598-604. doi: https://doi.org/10.1089/neur.2023.0040
Ahmed SM, Emran M, Hasan MI, Newaz F, Ahmed B, Khandaker MN, Emran MA. Correlation of pain, physical function and radiography with osteoarthritis of the knee. KYAMC Journal. 2020 Mar 1;10(4):173-8. doi: https://doi.org/10.3329/kyamcj.v10i4.45714
BSPMR - Bangladesh Society of Physical Medicine & Rehabilitation [Internet]. Bspmr.org. 2025 [cited 2025 Oct 2]. Available at: https://www.bspmr.org/ [Accessed on 15 Dec 2025]
Rahman MS. Community-based rehabilitation in Bangladesh, health components need to be integrated with primary health care. Journal of Enam Medical College. 2018 Feb 7;8(1):41-5. Available at: https://banglajol.info/index.php/JEMC/article/view/35435. [Accessed on 15 Dec 2025]
Rahman MM, Islam MR, Rahman MS, Hossain F, Alam A, Rahman MO, Jung J, Akter S. Forgone healthcare and financial burden due to out-of-pocket payments in Bangladesh: a multilevel analysis. Health economics review. 2022 Jan 10;12(1):5. doi: https://doi.org/10.1186/s13561-021-00348-6
Saha S, Reza SB, Mazid MA, Dewan SM. The Urgent Need for Developing a Common Health Insurance Policy in Bangladesh: A Perspective. Health Science Reports. 2025 Mar;8(3):e70554. doi: https://doi.org/10.1002/hsr2.70554
Koly KN, Abdullah R, Shammi FA, Akter T, Hasan MT, Eaton J, Ryan GK. Mental health and community-based rehabilitation: a qualitative description of the experiences and perspectives of service users and carers in Bangladesh. Community mental health journal. 2022 Jan;58(1):52-66. Available at: https://link.springer.com/article/10.1007/s10597-021-00790-0. [Accessed on 15 Dec 2025]
Bright T, Wallace S, Kuper H. A systematic review of access to rehabilitation for people with disabilities in low-and middle-income countries. International journal of environmental research and public health. 2018 Oct;15(10):2165. doi: https://doi.org/10.3390/ijerph15102165
Nuri RP, Aldersey HM, Ghahari S, Huque AS, Shabnam J. The Bangladeshi rights and protection of persons with disability act of 2013: A policy analysis. Journal of Disability Policy Studies. 2022 Dec;33(3):178-87. doi: https://doi.org/10.1177/10442073211066789
Uddin M, Ganapathy K, Syed-Abdul S. Digital Technology Enablers of Tele-Neurorehabilitation in Pre-and Post-COVID-19 Pandemic Era–A Scoping Review. International Journal of Telerehabilitation. 2024 Jun 28;16(1): e6611. doi: https://doi.org/10.5195/ijt.2024.6611
Louie DR, Eng JJ. Powered robotic exoskeletons in post-stroke rehabilitation of gait: a scoping review. Journal of neuroengineering and rehabilitation. 2016 Jun 8;13(1):53. doi: https://doi.org/10.1186/s12984-016-0162-5
Chang WH, Kim YH. Robot-assisted gait training in stroke rehabilitation. J Stroke. 2013;15(3):174–81. doi: https://doi.org/10.5853/jos.2013.15.3.174
Frontera WR, Stucki G, Engkasan JP, Francisco GE, Gutenbrunner C, Hasnan N, Lains J, Yusof YM, Negrini S, Omar Z, Battistella LR. Advancing academic capacity in physical and rehabilitation medicine to strengthen rehabilitation in health systems worldwide: a joint effort by the European academy of rehabilitation medicine, the association of academic physiatrists, and the international society of physical and rehabilitation medicine. Journal of the International Society of Physical and Rehabilitation Medicine. 2022 Jul 1;5(3):105-13. doi: https://doi.org/10.4103/ijprm.JISPRM-000168
Jesus TS, Landry MD, Hoenig H. Global need for physical rehabilitation: systematic analysis from the Global Burden of Disease Study 2017. Int J Environ Res Public Health. 2019;16(6):980. doi: https://doi.org/10.3390/ijerph16060980
Mutongi C, Rigava B. Robotics in Healthcare: The African Perspective. In2024 IEEE 3rd International Conference on AI in Cybersecurity (ICAIC) 2024 Feb 7 (pp. 1-10). IEEE. doi: https://doi.org/10.1109/ICAIC60265.2024.10433838
Neill R, Shawar YR, Ashraf L, Das P, Champagne SN, Kautsar H, Zia N, Michlig GJ, Bachani AM. Prioritizing rehabilitation in low-and middle-income country national health systems: a qualitative thematic synthesis and development of a policy framework. International Journal for Equity in Health. 2023 May 17;22(1):91. doi: https://doi.org/10.1186/s12939-023-01896-5
Slucock T. A systematic review of low-cost actuator implementations for lower-limb exoskeletons: A technical and financial perspective. Journal of intelligent & robotic systems. 2022 Sep;106(1):3. doi: https://doi.org/10.1007/s10846-022-01695-0
Prvu Bettger J, Resnik LJ. Telerehabilitation in the age of COVID-19: an opportunity for learning health system research. Phys Ther. 2020;100(11):1913–6. DOI: https://doi.org/10.1093/ptj/pzaa151
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Copyright (c) 2025 Md. Abdus Shakoor, Md. Israt Hasan, Fatema Newaz, Md. Abul Kalam Azad
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