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For many stroke survivors, regaining hand and arm function after experiencing post-stroke spasticity can be an incredibly difficult and frustrating journey. Traditional treatments like Botox injections or oral medications can offer temporary relief, but often come with side effects and inconvenience. But what if a new, non-invasive wearable technology could offer relief and promote lasting recovery?

Meet the VTS Glove. This wireless, glove-like device uses high-frequency vibrations to provide targeted therapeutic tactile stimulation to the hand and fingers. It is designed for daily, at-home use, allowing survivors to incorporate rehabilitation into their daily lives for approximately three hours a day.

A study recently published in the Archives of Physical Medicine and Rehabilitation found that daily use of the VTS Glove led to significant reductions in spasticity (involuntary muscle stiffness) and hypertonia (excessive muscle tone) in the hands of chronic stroke survivors. In the study, over half of the participants who regularly used Botox injections for spasticity found the VTS Glove to be as effective or even more effective in reducing their symptoms. The study found that positive changes persisted even one month after participants stopped wearing the glove, suggesting a potential for long-term retraining effects. Some participants also experienced improved voluntary finger extension and restored tactile sensation.

By reducing spasticity, the device can empower survivors to regain greater control and use of their affected hand. A patient at the University of Southampton, who was unable to move his hand for eight years after his stroke, was able to move it again with the help of a similar device, calling the experience ‘breathtaking.’ Since it can be used at home, the glove offers a more accessible and less disruptive therapy option compared to frequent clinic visits for injections or other treatments. Some participants in clinical trials reported voluntarily reducing or stopping their oral muscle relaxants or Botox injections, relying instead on the VTS Glove for symptom relief.

While the current research is very promising, more studies are planned to further explore the long-term effectiveness and optimal design of the device. For now, it represents a hopeful new frontier for stroke survivors and their caregivers.

Post-stroke recovery hinges on neuroplasticity; the brain’s ability to reorganise itself to compensate for injury. Intensive, repetitive, and task-specific training is key to driving this process. Innovative VR systems, sometimes incorporating devices like the Novint Falcon haptic arm, focus on restoring specific movements, such as the pinch grip. By simulating a sense of touch, weight, and friction, it creates a more immersive and effective therapeutic environment. They provide targeted force feedback during tasks to help patients regain fine motor control.

Research using the Novint Falcon (a notable early example) and similar haptic devices has provided encouraging results. Studies have shown that haptic-enhanced VR training can significantly improve fine motor functions, hand grasping abilities, and coordination in stroke survivors, even those in the chronic stage. The device’s ability to simulate tasks like handwriting and object manipulation provides a realistic, low-cost training tool.

By integrating gamified tasks, the Novint Falcon increases patient motivation and engagement. The engaging nature of the exercises promotes higher repetition and longer training sessions, which are crucial for optimal recovery. Beyond qualitative feedback, the Novint Falcon, when integrated into a research framework, allows for the precise, objective measurement of motor performance metrics like velocity and smoothness. This data helps clinicians track progress and fine-tune therapy protocols based on an individual patient’s needs.

Functional Magnetic Resonance Imaging (fMRI) studies have shown that haptic-mediated therapy can induce positive cortical reorganisation in the motor cortex of stroke patients. This demonstrates that the specific feedback from the haptic device can help ‘retune’ the brain towards a more normal activation pattern.

The Novint Falcon’s relatively low cost makes it a strong candidate for at-home rehabilitation. Also, combining it with a smartphone and a custom application allows for frequent, unsupervised practice, extending the reach of therapy beyond the clinic.

While promising, more large-scale, long-term studies are needed to confirm the durability of these effects and to fully understand how haptic training translates to real-world functional tasks. Integration with other technologies and exploring applications in other sensory-motor deficits also represent exciting avenues for future research.

The Novint Falcon exemplifies how affordable, consumer-grade technology can be adapted to provide powerful therapeutic benefits. This is a step beyond passive therapy and a leap towards a more active, data-driven, and engaging future for stroke rehabilitation!

The Vivistim Paired VNS System is leading the charge as one of the most exciting neurorehabilitation technologies of this year. This system combines Vagus Nerve Stimulation (VNS) with intensive task-specific therapy to drive neuroplasticity and deliver sustained, clinically significant improvements in chronic stroke survivors with moderate-to-severe upper extremity deficits.

The system delivers brief pulses of stimulation to the vagus nerve during a therapist-guided rehabilitation session. This pairing enhances the brain’s natural ability to reorganize neural circuits, reinforcing the connections needed for regaining arm and hand function, acting as a powerful reinforcement signal to the brain. VNS causes a rapid, widespread release of key neuromodulators throughout the cortex, including acetylcholine (ACh) and norepinephrine (NE).

When VNS is precisely paired with a specific motor task performed during physical therapy, these neuromodulators reinforce the neural activity related to that movement. This process strengthens existing neural connections and promotes the formation of new, more efficient neural pathways. Over time, this targeted reinforcement leads to a reorganisation of the motor cortex. The area of the brain controlling the specific rehabilitated movement expands, effectively rerouting the motor command around the damaged stroke area.

Recent findings (the VNS-REHAB trial) published in the last 2025 issue of Stroke validated the long-term effectiveness of the therapy. One year after completing the protocol, survivors maintained significant and clinically meaningful improvements in motor function, activity, participation, and quality of life. The trial also demonstrated that stroke survivors receiving paired VNS therapy had improvements in hand and arm function that were two to three times greater than those who received conventional rehabilitation alone.

For chronic stroke survivors who are often told that recovery potential plateaus, the Vivistim system clearly could offer new hope for regaining independence in daily tasks. The tech is safe, well-tolerated, and is gaining significant adoption within comprehensive stroke centres. For clinicians, it represents an evidence-based tool for expanding the therapeutic options available for chronic stroke rehabilitation.

Research is increasingly shedding light on the therapeutic potential of acupressure—a non-invasive, accessible therapy rooted in traditional Chinese Medicine, as an adjunct to conventional rehabilitation for stroke survivors to improve motor function, balance and mood, offering a promising, low-risk option for enhancing recovery.

A study last month in Frontiers of Neurology explored the use of finger acupressure combined with a lower limb rehabilitation machine in 80 stroke patients. The group receiving the combined therapy showed significant improvements in motor function and balance ability. This suggests that acupressure can boost the effects of modern rehabilitation equipment. Another RCT showed that a nurse-led acupressure program significantly improved motor function and ADL scores after three months, compared to routine care alone. This indicates that integrating acupressure can empower survivors to regain greater independence in their daily lives.

And another study in ischemic stroke patients found that a 14-point acupressure technique significantly increased muscle strength in both the upper and lower extremities over a 7-day period. This suggests acupressure can offer a fast-acting boost to muscle strength during critical early phases of recovery. Acupressure has also shown promise in addressing the emotional toll of stroke. Research on auricular (ear) acupressure on post-stroke depression (PSD) patients found it significantly reduced depression levels and improved their overall quality of life; the non-pharmacological nature of this intervention is a key advantage for many survivors.

Research has indicated a potential physiological mechanism, suggesting that acupressure modulates the autonomic nervous system. A placebo-controlled crossover study on stroke survivors found that active acupressure significantly and more rapidly reduced heart rate, indicating a greater relaxation response… this could be particularly beneficial for managing cardiovascular health post-stroke.

These studies suggest that acupressure, particularly when combined with conventional therapy or wearable devices, can be a safe and effective adjunct to stroke rehabilitation. Its non-invasive nature and potential for self-management make it a promising tool for both in-clinic and at-home recovery. Further large-scale, methodologically robust trials are warranted to fully confirm its efficacy and optimal application in practice.

Ref above: Liu X, Zhang F, Li Y, Zhao J, Du Y, Zhang Q, Li W. Effects of finger acupressure combined with lower limb rehabilitation training machine on stroke recovery. Front Neurol. 2025 Aug 22; 16:1609815.

For stroke survivors with persistent foot drop, the challenges of walking safely and efficiently are immense. While surface Functional Electrical Stimulation (FES) has been used for years, recent research highlights the significant advantages of implanted FES systems in improving mobility and quality of life.

Instead of using skin-surface electrodes, implanted FES involves a neurostimulator placed under the skin to directly stimulate the peroneal nerve, which controls the muscles responsible for lifting the foot. This offers a more precise and consistent stimulation, and is controlled wirelessly via a foot sensor or other external trigger.

A recent study compared the ActiGait® implanted system to traditional ankle-foot orthoses (AFOs) in stroke survivors. The findings were compelling: participants showed significantly higher success rates (Δ4.7%) in avoiding unexpected obstacles on a treadmill with the implanted FES. This benefit was even more pronounced for those with greater motor impairment. The unrestricted ankle mobility with FES is key for navigating real-world, uneven terrain.

While some systematic reviews found surface FES and AFOs to be equivalent in improving walking speed, the superior gait adaptability with implanted FES is a key differentiator. This means a more natural and less compensatory walking pattern.

By providing consistent electrical stimulation, implanted FES facilitates more efficient and repetitive muscle contractions. This intensive, task-specific practice is crucial for promoting neuroplasticity—the brain’s ability to rewire neural connections—which can lead to a therapeutic “carry-over” effect even when the stimulator is turned off. Research shows that survivors using implanted FES show an equivalent walking Speed to those using AFOs, with better gait adaptability. Survivors also often prefer FES over AFOs, citing greater comfort, improved cosmesis (appearance), and the ability to wear a wider range of footwear.

Implanted FES is a consideration for individuals with moderate to severe drop foot caused by an upper motor neuron lesion, such as from a stroke, who have a well-preserved peroneal nerve and sufficient cognitive function to manage the system.

Groundbreaking research is confirming the potential of Brain-Computer Interface (BCI) systems to revolutionise stroke rehabilitation. By directly linking a stroke survivor’s brain signals to an external device, BCI technology is proving to be a powerful tool for promoting motor recovery, especially for those with severe impairment.

BCIs use a ‘closed-loop’ feedback system, where brain signals reflecting the intention to move trigger a response from a connected device, like a robotic limb or functional electrical stimulation (FES). This process reinforces the neural pathways associated with the intended movement, effectively rewiring the brain to regain function.

Compared to traditional therapy alone, in stroke rehab research studies, BCI training is consistently showing significant superior effects in improving upper-limb motor function. Studies report clinically meaningful gains in Fugl-Meyer Assessment (FMA) scores. Meta-analyses show that BCI systems are most effective when combined with other technologies. BCI integrated with FES consistently demonstrates the highest effect sizes, likely because it activates both the brain’s intention and the muscle’s response, providing powerful and rich sensory feedback.

For survivors, BCI training can be incredibly motivating; by providing immediate, tangible feedback on progress, it can make training more engaging and rewarding, addressing the common challenge of low patient adherence. And non-invasive BCI methods, typically using EEG electrodes, are proven to be very safe and well-tolerated, with adverse effects being extremely rare. BCI represents a significant tech-driven leap forward; turning intention into action and offering new hope for us stroke survivors.

The RELab tenoexo 2.0 is an updated version of a wearable soft robotic hand orthosis designed to provide grasping assistance and support for rehabilitation in individuals with sensorimotor hand impairments, such as those following a stroke. This improved design features enhanced finger and actuation systems for greater simplicity and robustness, aiming to increase user independence and quality of life by facilitating high-dose, task-specific training in both clinic and home environments.

The latest findings on the RELab tenoexo 2.0 are of significant interest for our stroke rehabilitation community. A feasibility study just published in the Journal of NeuroEngineering and Rehabilitation demonstrates how this innovative, wearable device can significantly enhance hand and arm function for stroke survivors.

Researchers evaluated its effectiveness through a two-phase study involving individuals with chronic stroke. The survivors who used it achieved an impressive number of high-intensity repetitions, logging over 150 supported grasps per hour at home—a rate nearly five times higher than conventional therapy.

The intervention led to clinically meaningful functional gains in upper limb function, as measured by standardised tests like the Action Research Arm Test (ARAT) and Fugl-Meyer Assessment (FMA-UE). The functional gains observed were retained even one month after the intervention period ended, highlighting the therapy’s lasting impact. The study showed strong user acceptance and high adherence rates for both in-clinic and at-home training, proving its viability for continuous care.

For stroke survivors facing long-term hand impairments, accessing high-intensity, repetitive therapy is often a major challenge. The RELab tenoexo 2.0 clearly offers a useful addition to retraining solution as it’s a portable, easy-to-use tool. This approach can empower survivors to take control of their own recoveries, helping to promote neuroplasticity and improve independence in daily activities.

It looks to us at ARNI Stroke Rehab UK that wearable soft robotics are not just futuristic concepts; they are becoming a really useful augment to neurorehab.

Research continues to validate the effectiveness of advanced wearable technology, like the Neofect Smart Glove for upper-limb rehab. Smart Glove is a San Fran-based high-tech stroke rehab product for your hand that follows your hand motions, measuring the slightest movements in your hand with accelerometer and bending sensors while performing gamified exercises.

A recent study published in the Journal of NeuroEngineering and Rehabilitation showed significant functional gains for patients using the glove alongside conventional therapy compared to conventional therapy alone. It proved a motivating way to perform progressive hand exercises at home.

The Smart Glove uses engaging, game-based virtual reality to provide high-repetition, task-specific practice, a crucial component for inducing neuroplasticity. Integrated sensors monitor individual finger and wrist movements, giving patients and clinicians real-time feedback and objective tracking data on progress.

Functional near-infrared spectroscopy (fNIRS) analysis demonstrates increased brain activity in the motor cortex during Smart Glove training, providing objective evidence of cortical reorganisation. Patients showed statistically significant improvements in standardised tests of hand function (e.g., Fugl-Meyer Assessment and Jebsen-Taylor Hand Function Test).

This tech for stroke seems to offer a promising tool for increasing a survivor’s motivation and extending rehabilitation beyond the clinic; hopefully accelerating recoveries and improving the quality of survivors’ lives.

A new pilot programme at the Irvine Unit, Bexhill Hospital, is showcasing the power of collaborative, supervised exercise for stroke survivors. The Active Sussex Reconditioning Pilot demonstrates how targeted physical activity, delivered by health instructors alongside NHS physiotherapists, can significantly boost recovery. The pilot, which ran for six months, yielded significant, data-driven improvements.

Patients saw a substantial increase in their balance (balance across all survivors increased 50%), a critical factor for preventing falls and increasing mobility. Sit-to-Stand ability increased by 34%, indicating greater leg strength and functional independence in a key daily activity. The pilot also enabled greater independence for patients, with rehabilitation complexity reducing by 22%, potentially leading to faster and more successful discharges.

According to Karen Poole, AHP Rehabilitation Consultant at East Sussex Healthcare NHS Trust, the pilot demonstrated the power of cross-sector collaboration. She notes that ‘increased access to physical and social activity for patients contributed to their mood, wellbeing and a positive culture across our workforce.’

This initiative proves the potential for integrating fitness and healthcare sectors, with plans to expand the model to other hospitals across Sussex. This project highlights how innovative approaches to addressing inactivity can improve patient mood and wellbeing, challenging traditional rehabilitation models.

Subject to future funding, there are plans to expand this model by live-streaming exercise sessions to other hospitals in the region. This would enable wider adoption of the successful approach and potentially help inspire other NHS trusts to rethink their rehabilitation programmes.