The Effect of Myoelectric Orthoses on Post-Stroke Rehabilitation in Comparison to Traditional Therapy is Unclear from Current Literature

Alexandra Ogar, CFm, MSOP

Alexandra Ogar, CFm MSOP

Stance Health Solutions Resident

Creation Date 01/06/2026

Re-assessment Date 01/06/2031

Clinical Question

In adults with chronic upper-extremity hemiparesis following stroke, how does therapy using a myoelectric upper-extremity orthosis affect motor recovery, as measured by the Fugl-Meyer Assessment for Upper Extremity (FMA-UE), compared with conventional rehabilitation or baseline function?

Background

Stroke is a leading cause of long-term disability worldwide, with persistent upper-limb motor impairment limiting independence and quality of life. The FMA-UE quantifies motor impairment and is sensitive to changes from rehabilitation interventions.^1,2 Conventional therapy often emphasizes therapist-directed, high-repetition task practice to drive neuroplasticity.^3,4 Myoelectric orthoses, such as the MyoMo or MyoPro, amplify volitional muscle activity and may enable increased repetitions and engagement in motor learning programs. These devices have been categorized by CMS as a brace to support or restore function to a weakened or paralyzed arm. Although used primarily as a compensatory tool to facilitate completion of activities of daily living, clinicians have also incorporated myoelectric orthoses into restorative therapy regimens. However, evidence directly comparing myoelectric orthosis-assisted therapy to conventional rehabilitation or baseline function using the FMA-UE is limited. Although within-group improvements are frequently observed, clear evidence demonstrating superiority over conventional rehabilitation approaches remains inconclusive.⁵

Search Strategy

PubMed and the Academy’s O&P Knowledge Central (https://www.oandpknow.org/, formerly O&P IQ) were searched to cover publicly available literature.

Search Terms: (((((myopro) OR (myoelectric orthosis) OR (myomo)) AND (stroke rehabilitation)) AND (upper extremity myoelectric)) AND (fugl-meyer)) AND (stroke)

Inclusion/Exclusion Criteria: Included studies reporting FMA-UE outcomes with Myomo/Myopro therapy in stroke. Excluded studies that do not report motor impairment outcomes (FMA-UE), discuss a non-stroke population, were not part of a rehabilitation program, or were published more than 15 years prior (2011 - 2026).

Synthesis of Results

Four studies were identified (see Evidence Table). Evidence from the last 15 years evaluating myoelectric orthosis-assisted therapy for post-stroke upper-extremity recovery is limited and heterogeneous. One randomized controlled trial (RCT) comparing myoelectric orthosis-assisted to conventional repetitive task practice therapy⁶ found no significant differences in FMA-UE improvement, with all groups demonstrating similarly small gains (~2 points), indicating equivalence rather than superiority.

A pilot study,⁷ case series,⁸ and case study⁹ reported clinically meaningful within-group FMA-UE improvements; however, the absence of control groups and small sample sizes limit comparative conclusions.

Clinical Message

Overall, current evidence supports myoelectric orthoses as a feasible adjunct to therapy, but conclusions are constrained by limitations in sample size, heterogeneity, impairment severity, time since stroke onset, and differences in therapy settings and regimens. For a more definitive conclusion, larger, randomized, controlled studies are needed with current hand/wrist/elbow devices.