There is a growing call for health researchers to address the inequities in healthcare experienced by indigenous populations by focusing on the development of culturally responsive research approaches. This article presents a contextual example from Aotearoa New Zealand (NZ) of how indigenous (Māori) knowledge and practices helped reimagine and enhance an existing qualitative descriptive research protocol exploring clinicians’ perspectives of robotic rehabilitation for people with stroke. The intent was to develop a research design that upheld and valued mātauranga Māori (indigenous knowledge systems) alongside Western clinical sciences knowledge. To achieve this, a collaboration of non-indigenous (tauiwi) and indigenous researchers with experience in Qualitative and Kaupapa Māori (indigenous) methodologies, and clinical practice was formed. The researchers undertook a cyclical process of relationship building, engagement with mātauranga Māori, discussion and exploration of how indigenous knowledge and practices could inform and shape the existing study design. Key influences in adapting the research design were drawn from Māori ethical principles, Māori frameworks of health and wellbeing, and Māori cultural practices for clinical engagement. Drawing on indigenous knowledge and practices to develop a Māori-centred research method resulted in significant changes to the study design, methods, and interview approach. Focused development of a culturally responsive approach enabled the researchers to engage indigenous participants in a research process that was safe, respectful, and culturally appropriate. Transformation occurred within the researcher-participant relationship from one often characterised as transactional, to one of deeper connection and reciprocity, which facilitated a richer and more in-depth inquiry. The explicit valuing and integration of indigenous knowledge and practices in adapting the research method strengthened the cultural responsivity of the research. Central to the process was prioritising working in relational partnership. Non-indigenous researchers’ self-reflection on their own culture, alongside being attuned to the influence of historical, political, and social contexts of the participants experiences proved essential.

Background: Upper-limb impairment is a major cause of post-stroke disability, limiting participation in meaningful activities. Robotic rehabilitation may address this by delivering high-dosage, task-oriented training while reducing clinician workload. However, limited clinical translation of robotic interventions may be partly due to poor reporting in the literature. This systematic review evaluated the intervention-reporting quality (completeness and consistency) of randomized controlled trials (RCTs) comparing robotic and conventional upper-limb stroke rehabilitation. Methods: Four databases were searched for RCTs investigating robotic upper-limb interventions compared with dose-matched conventional interventions for people with stroke. Intervention reporting was assessed using the TIDieR-Rehab checklist. Trained reviewers independently extracted and evaluated data, resolving discrepancies through consensus. Completeness and consistency were analyzed descriptively. Results: Among 25 RCTs, the overall reporting completeness was low (43%). Robotic interventions were better described (50%) than conventional interventions (36%). While timing and total dose were commonly reported, critical details on provider expertise, active dose, progressive challenge, personalization, and harms were often omitted. Reporting consistency was moderate (68%), with key information dispersed across article sections. Conclusions: Inadequate reporting limits the transparency, replication, and implementation of robotic upper-limb interventions. Adopting structured reporting frameworks like TIDieR-Rehab is essential for advancing the field.

Upper limb impairment following stroke is common, contributing to restrictions in functional capacity and reduced quality of life. Robotic devices are being developed to augment rehabilitation and support upper limb recovery. However, a lack of end-user input has resulted in devices that fail to fully meet therapist and patient needs. In Aotearoa New Zealand, involving Māori (Indigenous) rehabilitation therapists is essential for developing culturally responsive devices and interventions. This qualitative study utilised a Māori-centred approach underpinned by Kaupapa Māori (Indigenous research) principles to explore the requirements for effective upper limb robotic rehabilitation with Māori following stroke. Semi-structured interviews were conducted with six Māori stroke rehabilitation therapists to explore their perspectives. Five interconnected themes were interpreted through thematic analysis. Inequities imposed by The system (Theme 1) and burden from The stroke (Theme 2) profoundly impact Māori people’s experiences of rehabilitation and recovery, requiring devices that avoid perpetuating or exacerbating these challenges. Hononga (Joining and connection) (Theme 3) highlights how robotic devices could support connections to Te Ao Māori (Māori worldview), whānau (family and communities), and meaningful activities. Whanaungatanga (Relationships) (Theme 4), emphasised the importance of building trusting relationships between therapists, patients, and whānau. Therapists can uphold Tino rangatiratanga (Self-determination) (Theme 5) by supporting Māori patients and whānau to have control over their rehabilitation. The participants’ clinical and cultural expertise provided valuable insights for advancing robotic device design and implementation, emphasising the importance of inclusive approaches that address the diverse needs of Māori and promote culturally responsive rehabilitation technology.