Author: ARNI Institute for Stroke Rehabilitation

Can I drive after a stroke?

ARNI Institute for Stroke Rehabilitation
August 28, 2025
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The deal is that after a stroke or TIA, car (and motorbike) drivers are not allowed drive for a minimum of one calendar month. Some people will be able to drive after the minimum period but others will have to stop for longer; some people will have to stop driving for good. It’s your responsibility to ensure you are safe to drive.

If your doc, therapist or eye specialist thinks you are not safe to drive, you must stop driving and contact the DVLA (if you don’t, you risk being fined up to £1,000). They might ask you to have a driving assessment. But even if nobody tells you to stop driving, it’s your responsibility to find out if you are able to drive after a stroke. This depends on several things including the type of stroke you had, its he effects and other medical conditions you may (now) have, like epilepsy.

If think your driving might be affected by stroke, a Driving Mobility centre can give you individual advice. They can tell you if you need to inform the DVLA (or DVA in Northern Ireland), who may arrange a driving assessment and support with going back to driving.

You also have to tell your motor insurance company if you have had a stroke or TIA. If you don’t, your insurance might be invalid. If you drive without insurance, you can be fined or lose your licence.

See the DVLA stroke guidance online or contact DVLA medical enquiries on 0300 790 6806 for advice about the process. Motorists in Northern Ireland can call the DVA on 0300 200 7861 for advice.

Gait control after stroke: moderate-intensity exercise versus high-intensity interval training

ARNI Institute for Stroke Rehabilitation
August 27, 2025
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The HIT-Stroke Trial 2 RCT is underway (in protocol stage). It examines moderate-intensity exercise versus high-intensity interval training to determine the optimal training intensity for walking rehabilitation in chronic stroke.

Current practice guidelines recommend moderate to vigorous intensity locomotor training to improve walking outcomes in chronic stroke. But these intensities span a wide range, and the lack of specificity may lead to under-dosing or over-dosing of training intensity.

We are sure that you already know that the evidence indicates that vigorous intensity locomotor training improves walking outcomes significantly more than moderate intensity. But previous studies have not been powered to rule out the possibility of meaningful risk increases or negligible benefit with vigorous versus moderate intensity, nor have they been designed to compare sustained effects after training ends.

In this single-blind, 3-site, randomized trial, 156 chronic (>6 months) stroke survivors will be allocated to 36 sessions (3 times a week for 12 weeks) of either high intensity interval or moderate intensity continuous locomotor training. Outcomes are assessed at baseline, after 4 weeks, 8 weeks, 12 weeks (POST), and 3 months after completing training.

The primary outcome is walking capacity (6-minute walk distance). Secondary outcomes include comfortable and fast gait speed, aerobic capacity, fatigue, balance confidence, quality of life, and motivation for exercise. Statistical analyses will compare outcome changes and adverse events between treatment groups, and will include subgrouping by walking limitation severity.

This study by Christine Garrity (Department of Rehabilitation, University of Cincinnati) and colleagues will hopefully provide important new information to guide greater specificity and individualization of locomotor training intensity in chronic stroke.

Birth control increases stroke risk: here’s what women need to know

ARNI Institute for Stroke Rehabilitation
August 26, 2025
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For millions of women, combined hormonal contraceptives are a part of their daily life – providing a convenient and effective option for preventing pregnancy and managing their menstrual cycle.

But new findings are sounding the alarm on a serious, and often overlooked, risk: stroke.

According to recent findings presented at the European Stroke Organisation Conference, combined oral hormonal contraceptives (which contains both oestrogen and progestogen) may significantly increase the chance of women experiencing a cryptogenic stroke. This is a sudden and serious type of stroke that occurs with no obvious cause.

Surprisingly, in younger adults – particularly women – cryptogenic strokes make up approximately 40% of all strokes. This suggests there may be sex-specific factors which contribute to this risk – such as hormonal contraception use. These recently-presented findings lend themselves to this theory.

At this year’s conference, researchers presented findings from the Secreto study. This is an international investigation that has been conducted into the causes of unexplained strokes in young people aged 18 to 49. The study enrolled 608 patients with cryptogenic ischaemic stroke from 13 different European countries.

One of their most striking discoveries was that women who used combined oral contraceptives were three times more likely to experience a cryptogenic stroke compared to non-users. These results stood, even after researchers adjusted for other factors which may have contributed to stroke risk (such as obesity and history of migraines).

Average time to call 999 for stroke incidents shown to be 1.5 hours

ARNI Institute for Stroke Rehabilitation
August 25, 2025
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A new campaign by the NHS in England is encouraging people who experience the first sign of a stroke not to delay calling 999, after analysis of calls made in the last year showed the average time to do so was nearly an hour and a half.

England’s most senior doctor says stroke symptoms might not appear obvious or dramatic, but they are always a reason to act quickly.

About 100,000 people have a stroke each year in the UK and more than a third die from related issues, making it the fourth biggest cause of death in the UK.

The most common symptoms are struggling to smile or raise an arm, and slurring words when speaking.

NHS England says recognising any one of these signs in yourself or others and dialling 999 urgently is crucial to getting prompt, specialist treatment.

Yet the average time taken to make that emergency call was 88 minutes in 2023-24, NHS data reveals.

The analysis, from a team at King’s College London, looked at data for more than 41,000 stroke patients who were taken by ambulance to hospital.

NHS England also said a recent poll they carried out found a mistaken belief that two or three stroke symptoms were necessary before calling 999.

UK upper-limb study in South West & East: FES and VR combo

ARNI Institute for Stroke Rehabilitation
August 24, 2025
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‘v-health’ pairs virtual task-based games with Valkyrie’s patented FES wearables with the goal of delivering accessible and measurable upper limb training for stroke survivors to help them regain function and independence.

The combination of immersive XR and neuromuscular stimulation is intended to encourage repetitive movement, assist motor relearning, and support patient engagement. A British technology company has received £500,000 in funding to further develop a neurorehabilitation platform that combines electrical stimulation with virtual reality.

Valkyrie Industries was awarded a grant through the Biomedical Catalyst 2024 competition by Innovate UK, part of UK Research and Innovation (UKRI). The funding will support the continued development of v-health, Valkyrie’s platform designed for neuromuscular rehabilitation using functional electrical stimulation (FES) and extended reality (XR).

The project is backed by King’s College London, Guy’s and St Thomas’ NHS Foundation Trust.

The study will enrol 70 stroke survivors across the Guy’s and St Thomas’ NHS Foundation Trust and the 6 Hobbs Rehabilitation sites in the South West and East. Focusing on individuals across a wide range of stroke recovery with wrist weakness, the research will assess the impact of the v-health platform during motor learning tasks.

Participants with wrist weakness across varying stages of stroke recovery will take part in motor learning exercises using the v-health system. The research aims to evaluate both the effectiveness and practical application of the platform in healthcare settings.

Regain function with Nura FES: a (currently in prototype & patent pending) wearable FES sleeve

ARNI Institute for Stroke Rehabilitation
August 22, 2025
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More than 70% of people experiencing stroke suffer upper-limb dysfunction, which can significantly limit independence in daily life. The growing strain on national healthcare resources, coupled with the rising demand for personalised, home-based rehabilitation, along with increased familiarity with digital technologies, has set the stage for developing an advanced therapeutics system consisting of a wearable solution aimed at complementing current stroke rehabilitation to enhance recovery outcomes.

Very long-term friend and supporter of ARNI, Professor Cherry Kilbride , and her colleagues, have developed an advanced prototype integrating electromyography smart sensors, functional electrical stimulation, and virtual reality technologies in a closed-loop system that is capable of supporting personalised recovery journeys.

The outcome; Nura, is a more engaging and accessible rehabilitation experience, designed and evaluated through the participation of stroke survivors. It features a comfortable sleeve with embedded fabric electrodes and a detachable “puck” that delivers FES to the arm muscles to aid in rehabilitation. The device is controlled by a companion tablet app that provides gamified exercises to motivate users and features simple, one-touch controls for FES intensity adjustment.

Key Features:

Wearable Sleeve: A comfortable sleeve with fabric electrodes that are integrated directly into the fabric, avoiding skin irritation.

“Puck” Controller: A detachable electronic component that houses the technology, including the microcontroller, which delivers the FES to the arm.

Gamified Rehabilitation: The device works with a tablet or Virtual Reality (VR) application, offering gamified exercises to enhance user engagement and motivation during rehabilitation.

Functional Electrical Stimulation (FES): Nura uses FES to stimulate arm muscles for wrist extension, ulnar, and radial deviation, helping to prevent muscle wastage.

User-Friendly Controls: The system allows for one-touch adjustment of FES intensity through the companion app, making it intuitive to use.

Biomedical Integration: The technology incorporates electromyography (EMG) sensors, which measure electrical activity in the muscles, and is designed to be integrated with existing rehabilitation and healthcare systems.

Targeted Audience: The Nura FES device is developed with stroke survivors in mind, especially those with cognitive impairments, providing a user-friendly and engaging way to regain strength and function.

Stroke costs survivors nearly £20k in lost earnings over 5 years

ARNI Institute for Stroke Rehabilitation
August 21, 2025
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According to a recent analysis from the @OfficeForNationalStatistics, the average stroke survivor loses £18,785 in earnings over a five year period, from the moment of their diagnosis. This is more than:

▪️Cancer
▪️Heart failure
▪️Heart attack
▪️Chronic kidney disease
▪️Diabetes
▪️Respiratory conditions
▪️Musculoskeletal conditions

From these conditions, stroke survivors were also least able to stay in permanent employment, four years after their diagnosis. This is clear evidence that more needs to be done to provide financial security for stroke survivors and their families, and yet the current Government insists on making it more difficult for people living with disabilities and long-term health conditions to access benefits like Personal Independence Payment (PIP).

We already know how difficult stroke survivors find the process of applying for PIP, and how many people are unsuccessful. If the Government continues with its current plan to introduce stricter measures and barriers to PIP and financial support, more and more stroke survivors are going to be left with less and less.

Spatial inattention: researching a new and promising therapy

ARNI Institute for Stroke Rehabilitation
August 21, 2025
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The largest study of a spatial inattention therapy to take place anywhere in the world is underway at the University of East Anglia and taking place at eight major stroke centres across England.

There are 1.3 million stroke survivors in the UK, with an estimated 390,000 of those suffering from spatial inattention. The condition can be highly persistent, with 40% of stroke survivors continuing to experience symptoms a year post-stroke.

Currently there is no effective treatment for spatial inattention. This new trial is helping to fill the gap in the urgent search for successful treatments.

A stroke is caused by blood supply being cut off to part of the brain, killing brain cells. This can affect the brain’s ability to interpret information. In some cases, this can make the stroke survivor lose attention to things on one side of their body. This means that even if they have good eyesight, their brain does not process the information it’s getting from the impaired side, resulting in a disabling cognitive condition called ‘spatial inattention’ or ‘spatial neglect’.

SIGHT (Spatial Inattention Grasping Therapy) requires those suffering from spatial neglect to grasp and balance rods with their less affected hand. Because of the condition, the rods tilt during the first attempts, but feeling and seeing the rod tilt improves performance, which in turn increases attention to the impaired side.

The study will also explore why some people benefit more from therapy than others. To help identify who might benefit most, the trial will measure grasping, vision, cognition, stroke severity and brain structure and function.

There is currently no effective treatment for spatial inattention and people affected by it often have poor recovery and long-term disability. However this new therapy, SIGHT, has already shown some early promise in improving the condition. This low-cost, portable therapy, if found to be effective at improving inattention, could benefit millions of people around the world.

Calling all stroke survivors: vagus nerve stim for your upper-limb rehab

ARNI Institute for Stroke Rehabilitation
August 21, 2025
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Calling stroke survivors! Researchers are recruiting now for a large-scale clinical trial with the acronym TRICEPS, run in 19 centres around the country: Sunderland, Leeds, Bradford, Manchester, Liverpool, Sheffield, Doncaster, Leicester, Birmingham, Norwich, London, South Petherton, Sherbourne, Bournemouth, Bodmin & Cardiff.

The trial is looking at how a specialised device can help strengthen hand and arm function, using a small earpiece to stimulate the vagus nerve. Called transcutaneous vagus nerve stimulation (TVNS), it forms part of rehabilitation therapy, and involves sending mild electrical pulses to the brain. Patients will be asked to wear it while they move their weak arm. The stimulation is automatically activated as the arm is moved during therapy and the connected earpiece gently tickles the ear. This can be done at home and does not involve invasive surgery.

You may be eligible if;

✅- You STILL HAVE arm weakness as a result of a stroke that happened between 6 months and 10 years ago

✅- You DO HAVE SOME movement of your arm, wrist, and fingers

✅- The TYPE OF STROKE that you had was ISCHAEMIC

✅- You ARE AGED 18 years and over

✅- You ARE WILLING to wear a TVNS device (earpiece, wrist sensor and stimulator), whilst you do some home based self-delivered therapy for 1-hour, 5 times a week. This will be over a 12-week period.

✅- You ARE WILLING to attend at least 3 appointments during the 6 months of taking part in the trial.

If selected, you will wear the TVNS device when completing the self-delivered rehabilitation therapy for 1 hour per day, 5 days per week for 12 weeks. The rehabilitation therapy plan will be tailored to you. It will be completed at home, and includes repetitive tasks such as turning cards, moving objects, opening, and closing bottles. Some patients will also be asked to wear the TVNS device whilst undertaking their daily activities, such as cooking.

Involving yourself in this study may be of benefit to some survivors who may not be receiving any other therapy for their arm weakness. https://youtu.be/EA_XrKvM8KQ

Cardio exercise after stroke is associated with neuroplasticity & better functional recovery

ARNI Institute for Stroke Rehabilitation
August 20, 2025
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A Canadian research group has found evidence not only that doing more exercise is associated with greater gains in function and motor recovery but that cardiorespiratory exercise aids stroke recovery by promoting neuroplasticity.

Despite the benefits of cardio exercise early post-stroke, physiotherapists perceive that people who have had a stroke have rehabilitation goals related to improving physical function rather than addressing physiological impairments underlying function such as low cardiorespiratory fitness, which leads them to de-prioritize cardio exercise during limited therapy time.

Few clinical trials investigating the benefits of doing cardio exercise during stroke rehabilitation on functional recovery have been conducted to date but systematic reviews have reported that people with stroke who complete cardio exercise experience improved certain aspects of cognitive function, such as attention and processing speed, but not memory, problem-solving, executive function, or working memory.

Providing further evidence for a link between cardio exercise and improved outcomes, the group found that higher total time spent in cardio exercise correlated with greater improvement in total FIM (Functional Independence Measure), FIM motor and cognitive sub-scores, FAC, and CMSA arm, leg, and foot scores. These results indicate that a higher dose (ie, increased duration) of cardio exercise could lead to greater gains in functional independence.

Sarah Thompson, Augustine J. Devasahayam, Cynthia J. Danells, David Jagroop, Elizabeth L. Inness, Avril Mansfield,
Cardiorespiratory exercise during rehabilitation is associated with improved functional recovery early post-stroke: A cohort study,
Annals of Physical and Rehabilitation Medicine, Volume 68, Issue 8, 2025.

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