## 3 Results  
After the databases were searched, 320 records were identified, of which 29 were assessed for full-text screening eligibility. Finally, ten studies were included in the qualitative analysis that verified the effect of robotic therapy in the upper limb rehabilitation in PwMS [16; 29; 30; 31; 32; 33; 34; 35; 36; 37]. A summary of the search and study selection process is shown in Figure 1.  
The ten selected studies included one systematic review [16]; four RCTs [29; 30; 32; 33]; one randomized crossover study [35]; and four case series [31; 34; 36; 37]. A summary of the characteristics and results of the included studies are reported in Table 1.  
Figure 1: Flowchart of number of articles retrieved during the literature search and study selection. \begin{table}
\begin{tabular}{c c c c c c} \hline \hline  
\begin{table}
\begin{tabular}{c c c c c c} \hline \hline
**Author, Year** & **Study Design** & **Population** & **Intervention** & **Outcomes** & **CEBM Level** \\ \hline [PERSON] et al., & & & & **R**: shoulder, elbow, forearm, wrist training & & \\ [PERSON] et al., & & 5 PwMS: 1 PP, 3 SP, 1 RR & & (Armec Spring, Hocoma, Switzerland) + FES & (+) FMA proximal arm & \\
2016 & Case Series & SP, 1 RR & & & section, the accuracy of \\  & & EDSS NA & **C**: NA & tracking performance & \\  & & & & period. frequency not described & \\ \hline  & & & **R**: shoulder, elbow, forearm, wrist & & \\  & & & & robot-assisted training + conventional & (+) patients’ reported & \\  & & 17 PwMS: 2 PP, & multidisciplinary therapy (Haptic Master, & beneficial changes in & \\  & & 14 SP, 1 RR & MOCO, Netherlands) & daily use, robotic & \\ [PERSON] et al., 2015 & RCT & EDS8 8 & **C**: conventional multidisciplinary therapy & instrumental assessment & 2 \\  & & & **D**: 24 sessions, 3 times a week for 8 weeks. & No between-group & \\  & & & Session lasting 30 min of robotic therapy & differences & \\  & & & & and 2 h of conventional therapy. & \\ \hline  & & & **R**: shoulder, elbow, forearm, wrist, & & \\  & & & robot-assisted reaching task (Bracció di & \\  & & & & Ferro) and object manipulation (RMT) & (+) grasp—ARAT, TSS & \\ [PERSON] et al., 2012 & RCT & 12 SP, 6 RR & **C**: shoulder, elbow, forearm, wrist, & & RMT was superior to RT \\  & & & & robot-assisted reaching task, RT (Bracció & on grasp (ARAT) changes \\  & & & & (\(p\) = 0.035) & \\  & & & & (\(p\) = 0.035) & \\  & & & & & \\  & & & & & \\  & & & & & \\ \hline  & & & **R**: shoulder, elbow, forearm, wrist passive & & \\  & & 9 PwMS: 3 PP, 6 & training (Armec Spring, Hocoma, & \\  & 2011 & Case Series & SP & Switzerland) + usual care & (+) 9 HPT, TEMPA & \\  & & & & & (+) TEMPA, ARAT at 2 & \\  & & & & EDSS 7-8.5 & **D**: 24 sessions, 3 times per week for 8 weeks, 30 min/session & \\ \hline  & & & **R**: shoulder, elbow, forearm, wrist & & \\  & & & & robot-assisted training (Bracció di Ferro) & & \\  & & & & with error-enhancing (EE) forces & (+) TADL in the first 4 & \\ [PERSON] et al., & & Double-Blind & REEDS8 5 & **C**: shoulder, elbow, forearm, wrist & & sessions only in the EE \\
2010 & Crossover & Cerebellar & robot-assisted training (Bracció di Ferro) & group & 4 \\  & Design & deficits & & & \\  & & & & **D**: 8 sessions (4 EE, 4 ER), 2 times a week & No between-group & \\  & & & & for 4 weeks, 498 movements each session. & & \\  & & & & Session lasting 60 min. & \\ \hline  & & & **R**: shoulder, elbow, wrist shoulder, elbow, & & \\ [PERSON] & & & & forearm, wrist, robot-assisted reaching & & \\ [PERSON] et al., 2009 & Case Series & 7 PwMS: 1 PP, 4 & & & \\  & & & & task (Bracció di Ferro) & (+) 9 HPT and robotic & \\  & & & & & instrumental assessment & \\  & & & & **D**: 8 sessions, 5 times a week, 200 & & \\  & & & & movements each session. & & \\ \hline  & & & &  
In the studies that reported this information [30; 32; 37], the most affected arm was usually selected for robot-assisted training. In PwMS, both end-effectors [29; 32; 33; 35; 36; 37], a passive exoskeleton [31; 34], and a hand robot [30] have been used in rehabilitation so far.