Cost and economic evidence of stroke technology-assisted rehabilitation: a scoping review

Abstract

In recent years, the growing demand for cost-effective rehabilitation after stroke has motivated the development of novel technologies to support high-intensity rehabilitation. However, available knowledge on the economic benefits of stroke technology-assisted rehabilitation (TAR) is relatively scarce and fragmented. Therefore, this scoping review aimed to review evidence on the economic benefits of TAR in laboratory, clinical, and home settings, as well as the methodologies used to evaluate these outcomes. A systematic search of four electronic bibliographic databases and two additional grey literature/ economic evidence sources (until 03 June 2026) identified 6469 records. Following predefined inclusion and exclusion criteria, 44 records were considered for further analysis. Additionally, 21 records were identified through a citation search. In total, 65 articles reporting TAR-related costs were included, but only a few of these studies reported cost analyses (mostly cost comparisons). Firstly, of the 38 studies conducted in laboratory settings, only one reported a formal TAR-related cost analysis. Secondly, out of 16 studies reporting costs, 11 studies performed cost analysis for TAR in clinical settings. Of these, the majority (six) estimated TAR to be equally effective or even superior (one) and cheaper than conventional therapy (CT) in the clinic, but only when TAR enabled the therapist to treat several stroke survivors in parallel. This was captured using the relative therapist-to-patient ratio (rT/P), indicating that staffing and supervision models were more important than device cost. Lastly, seven of 13 studies conducted TAR-related cost analysis in a home setting. Three studies suggested that TAR may be economically beneficial compared with CT in the clinic. Empirical findings suggest that TAR may generate cost savings compared to CT in the clinic, particularly when rT/P is < 0.5. However, the current evidence is sparse, with limited comparability and generalisability due to heterogeneous TAR modalities, comparators and cost-calculation methods. Not applicable.