Your Stroke / Brain Injury Recovery Starts Here


ARNI home-based training and guidance for your rehab is POWERFUL. Accept no substitute.

To mark 20 years of ARNI: £50 off Full Set of Stroke Rehab 7 DVDs. Click Here to Get Yours!

News

Upper limb robots can supplement ARNI training by assisting with intensive, repetitive exercises that might otherwise be too demanding for trainers or therapists to deliver or us stroke survivors to manage to do. The best results are seen clinically when robotic therapy is combined with conventional methods, and different robots are suited for varying needs.

Upper limb exoskeletons provide assistance tailored to the patient’s needs and stage of recovery. They can support full limb movement for those with very limited function, offer support only when needed as motor control improves, gently guide the limb back to the correct path if movement deviates, and even provide resistance for more advanced patients working to regain strength. Robotics can deliver a higher dosage of repetitive, task-oriented exercises and provide consistent, objective data to track progress. They can be broadly categorised into two types based on their function and how they interact with the stroke survivor:

* End-effector devices, which are independent of the patient and attach at a single, distal point, such as the hand… and are effective for training movements in a horizontal plane but are less capable of controlling and isolating the movement of individual joints.

* Exoskeleton devices, however are wearable, powered devices resemble and attach directly to the human arm, with their joints aligned to mimic human joints, which allows for assisted movement of specific joints in the hand, wrist, elbow, and shoulder. Upper limb exoskeletons operate in several modes to help with different stages of recovery:

  • Assistive mode: For patients with very little to no movement, the exoskeleton fully supports the limb and helps the patient perform the desired motion.
  • Assist-as-needed (AAN) mode: As the patient recovers some motor function, the device detects their initial movement intention and provides support only when needed to complete the task.
  • Corrective mode: This mode provides force to gently guide the limb back toward the correct trajectory if the patient’s movement deviates from the desired path.
  • Resistive mode: For patients with significant motor recovery, the exoskeleton can provide resistance to help them regain strength and better control their movements.

Integrating exoskeletons into stroke rehabilitation offers several advantages. They enable high-intensity, repetitive, and task-specific training crucial for motor relearning, which is difficult to achieve manually. Many systems also enhance patient engagement through virtual reality and gamification. Exoskeletons provide objective data on performance and range of motion, helping therapists track progress and customize treatment. Some portable devices also allow for easier access to rehabilitation at home.

Despite their potential, challenges remain. Exoskeletons can be costly and are not always readily available. Proper fitting is also essential for comfort and effectiveness due to the potential for misalignment with human joints. While exoskeletons can improve upper limb function, transferring these gains to daily activities and maintaining them long-term is an area that requires further research and optimization.

A new glove-based system that uses functional electrical stimulation (FES) to activate individual fingers could offer a more effective way to support hand rehabilitation in people recovering from stroke or spinal cord injuries.

The FESGlove delivers targeted electrical stimulation to specific hand muscles and nerves, offering greater selectivity than many current systems, which often cause unintended finger movements by stimulating larger forearm muscles. The device features 10 independent stimulation channels and combines silver fiber and hydrogel electrodes within a stretchable glove. Users can adjust settings like frequency, current amplitude, and pulse width to suit different needs.

The FESGlove isn’t just for a clinical setting—they can be used at home, allowing for longer, more frequent, and more convenient rehabilitation sessions. The benefits include:

  • Improved dexterity: With targeted stimulation, users can practice fine motor skills needed for tasks such as grasping small objects.
  • Increased muscle strength: Repetitive, functional movements performed with the glove help rebuild strength in weakened hand muscles.
  • Reduced spasticity: The technology has been shown to reduce muscle tone and spasticity, especially in the wrist, which can interfere with movement.
  • Enhanced independence and quality of life: By enabling users to perform daily activities with greater ease, FESGlove could restore confidence and significantly improve quality of life.
  • Motivation for therapy: For many users, being able to perform tasks they haven’t been able to do for years provides powerful motivation to continue with their therapy.

Developed by researchers at the University of Bath and Shanghai Jiao Tong University (and published in the journal Neuroelectronics in June 2025) , the glove was designed to overcome limitations in traditional rehabilitation techniques that often fail to restore the fine motor control needed for tasks like buttoning a shirt or typing. The research team sees the FESGlove as a potential platform that could eventually be integrated with brain-computer interfaces and other advanced neurorehabilitation tools.

A quick warning: FES treatment is not for everyone. They are most effective when the nerve pathways between the spinal cord and the hand muscles are still intact. Contraindications include having a pacemaker, defibrillator, or uncontrolled epilepsy. As with any medical device, consultation with a healthcare professional is necessary to determine suitability.

In the coming years, stroke rehabilitation is set to be transformed by advances in technology and a deeper understanding of the brain’s ability to heal. A move away from one-size-fits-all treatments will be replaced by highly personalized, tech-driven approaches that improve outcomes, especially for chronic stroke survivors. The shift toward precision medicine, powered by technologies like artificial intelligence (AI), is a major development in neurorehabilitation. AI algorithms can analyze a patient’s data from various sources to create customized treatment plans that adapt in real-time to their progress.

  • Predictive modeling: Machine learning models predict patient recovery trajectories based on clinical assessments, demographics, and neuroimaging. This information helps therapists set realistic goals and decide on the most effective interventions.
  • Targeted therapy: A deeper understanding of neuroplasticity—the brain’s ability to reorganize itself—is enabling more targeted therapies. For example, studies in chronic stroke patients show that the window for meaningful recovery can be extended well beyond the initial acute phase.
  • Focus on hidden disabilities: While traditional rehab has focused on motor function, recent research highlights the need to address non-motor symptoms like fatigue, pain, and psychological issues. Personalized plans will incorporate these factors to improve overall quality of life.

Several groundbreaking technologies are moving from research labs to clinical practice, promising to maximize patient progress.

  • Robotics and exoskeletons: Robotic-assisted therapy provides highly repetitive, intensive training that speeds up motor recovery. Wearable exoskeletons can assist with gait rehabilitation, helping patients relearn how to walk.
  • Virtual reality (VR): VR creates immersive, engaging environments where patients can practice functional tasks in a safe, controlled setting. This technology can be tailored for motor and cognitive rehabilitation, enhancing motivation and recovery.
  • Brain-computer interfaces (BCI): For patients with severe motor impairments, BCI technology offers a path to regaining function. By decoding a patient’s motor intentions from their brain signals, BCIs can control external devices or trigger functional electrical stimulation (FES) to assist with movement.
  • Wearable sensors: Wearable technology tracks movement, gait, and daily activity in real-world settings. This objective data helps clinicians monitor progress, adjust therapy, and provides patients with a tangible record of their recovery.
The future of rehab will not be confined to hospital walls. Telemedicine and in-home technology will play a crucial role in delivering care.
  • Telerehabilitation: Remote rehabilitation services delivered via communication technology can increase access to therapy, reduce costs, and improve adherence by allowing patients to continue their exercises at home.
  • Home-based therapy: AI and wearable sensors can create personalized, home-based programs with real-time feedback, enabling patients to perform high-intensity therapy in their own environment.
  • Long-term engagement: Combining engaging VR games, remote monitoring, and personalized feedback can help overcome plateaus and encourage continued practice long after formal therapy ends.
While the future of stroke rehab is bright, its successful implementation depends on a collaborative, patient-centered approach.
  • Interdisciplinary collaboration: Clinicians, researchers, engineers, and technology developers must work together to create effective, user-friendly solutions that translate research into practice.
  • Addressing the digital divide: It is crucial to ensure that technology-driven rehabilitation is accessible to all, addressing issues of cost, connectivity, and digital literacy.
  • Ethical considerations: As AI and BCI become more integrated, ongoing discussions are needed to address data privacy, security, and algorithmic bias.
The landscape of stroke rehabilitation is evolving, offering newfound hope to survivors. By harnessing these technological and scientific advances, we at ARNI are sure that the future promises a more personalised, accessible, and ultimately more effective recovery journey for all.

Following stroke, a foot drop gait is common, affecting 20 to 30 per cent of stroke survivors (Peishun et al., 2021). We know that for decades, the standard of care has involved Ankle-Foot Orthoses (AFOs)—passive, rigid braces that stabilises the ankle but rather fails to promote active muscle engagement. However, a new frontier of technology, including advanced neuro-prosthetics, wearable exoskeletons, and smart orthoses, is revolutionising how we treat foot drop, shifting the focus from passive compensation to active rehabilitation.

Functional Electrical Stimulation (FES) has been a significant advancement over traditional AFOs. Recent research is focused on creating smarter, more adaptive FES systems. Novel algorithms now use information from muscle synergy patterns—the coordinated activation of multiple muscles—to optimize stimulation delivery and create a more natural gait. Implantable FES systems, with electrodes placed directly on the nerve, offer an even more discreet and comfortable experience by eliminating the need for surface electrodes.

The rise of the Internet of Things (IoT) and smart sensor technology is creating new possibilities for personalised and home-based rehabilitation. Instead of static plastic, modern orthoses can incorporate sensors to provide real-time feedback on walking patterns.

* Real-Time Feedback: In-shoe sensors can track gait metrics like pressure distribution and foot inclination, providing immediate feedback to both the user and clinician.

* Tele-rehabilitation: Mobile apps linked to smart devices allow for remote monitoring, personalized guidance, and progress tracking, empowering patients to continue therapy at home.

* Aesthetic and Comfort-Focused Design: Innovations like the “HDC Shoe” prioritise aesthetics and discretion, overcoming a major barrier to patient acceptance of traditional, bulky AFOs.

Technology is fundamentally changing the prognosis for stroke survivors with foot drop. As research moves from single-technology solutions to hybrid systems, integrating robotics, FES, and AI, we are moving closer to a future where rehabilitation is truly personalised.

For many stroke survivors, regaining arm and hand function is a difficult and often frustrating process. Traditional rehabilitation methods, while foundational, can be intensive, repetitive, and limited by therapist availability. In the months immediately following a stroke, the brain exhibits enhanced neuroplasticity; a critical window for recovery that requires as much task-specific practice as possible in order to take advantage it. Increasingly, a wave of new technologies is revolutionising upper limb rehabilitation, offering innovative and engaging ways to target and extend this time-window as much as possible by supplementing conventional therapy.

Virtual Reality (VR) is transforming monotonous exercises into interactive games, boosting patient engagement and motivation. Studies have shown that when used alongside traditional therapy, VR can significantly improve motor function and quality of life for stroke survivors.

Immersive or non-immersive VR systems—using head-mounted displays, computer screens, or tablets—place patients in virtual environments where they can practice real-world tasks. A patient might use a motion-tracking glove to “catch” objects in a virtual space, or practice hand movements in a simulated kitchen to promote greater engagement. Real-time feedback can be delivered; gamification, and task-specific training in a safe, controlled environment can increase exercise intensity and provide an enjoyable experience.

Robotic devices can also supplement therapy by assisting with intensive, repetitive exercises that might otherwise be too demanding for therapists or patients. The best results often occur when robotic therapy is combined with conventional methods, and different robots are suited for varying needs.

Robotics can deliver a higher dosage of repetitive, task-oriented exercises and provide consistent, objective data to track progress.

Rehabilitation robots can be broadly categorised into two types based on their function and how they interact with the stroke survivor: end-effector devices, which are independent of the patient and attach at a single, distal point, such as the hand… and are effective for training movements in a horizontal plane but are less capable of controlling and isolating the movement of individual joints. Exoskeleton devices, however are wearable, powered devices resemble and attach directly to the human arm, with their joints aligned to mimic human joints, which allows for assisted movement of specific joints in the hand, wrist, elbow, and shoulder.

Upper limb exoskeletons operate in several modes to help with different stages of recovery: 
  • Assistive mode: For patients with very little to no movement, the exoskeleton fully supports the limb and helps the patient perform the desired motion.
  • Assist-as-needed (AAN) mode: As the patient recovers some motor function, the device detects their initial movement intention and provides support only when needed to complete the task.
  • Corrective mode: This mode provides force to gently guide the limb back toward the correct trajectory if the patient’s movement deviates from the desired path.
  • Resistive mode: For patients with significant motor recovery, the exoskeleton can provide resistance to help them regain strength and better control their movements. 

Functional Electrical Stimulation (FES) uses electrical pulses to activate muscles artificially, helping to practice functional tasks like grasping and reaching. When coupled with voluntary movement, this technique can help promote neuroplasticity, the brain’s ability to reorganize itself. Surface electrodes can be placed on the skin, or in more advanced setups, integrated into electrode arrays on a fabric sleeve or orthosis.

Some systems are also triggered by electromyography (EMG) or brain-computer interfaces (BCIs), allowing the patient’s intent to control the stimulation. By actively involving the patient’s brain and body, FES reinforces connections between intention and movement, which is crucial for recovering motor control.

Portable, wearable sensors and smart devices enable rehabilitation to extend beyond the clinic and into the home. This provides continuous monitoring and feedback, which is key for maximizing recovery through high-intensity, repetitive practice.

Wearable sensors take the form of wrist-worn sensors or special gloves can track arm movements and provide real-time feedback through a tablet or app. Gamified devices have also been available for many years. Both the following are produced by long-term colleagues of ARNI: GripAble, is a great example which turns exercises into engaging, fun activities for at-home use. And Neuroball is used to play video games that track hand and arm movements. It’s designed to motivate users to complete hundreds of physical therapy repetitions from home. Such examples help to maintain patient motivation and exercise adherence outside of supervised sessions.

To sum; technology is not seen currently by experts in stroke as a replacement for therapists, but as a powerful partner able to deliver high dosages of repetitions in order to complement therapy or retraining interventions. By combining these advanced tools with expert guidance, survivors can achieve levels of recovery that were once impossible.

We predict that that the future of stroke rehabilitation will continue to see these technologies becoming more personalised, accessible, and integrated into a holistic approach that can help stroke survivors ultimately to reclaim function and independence as they seek to retrain & recover autonomy in the community.

Recent news in stroke rehabilitation highlights advancements like using retro video games for cognitive and motor recovery, new wearable robotic devices to assist with arm and leg movement, and high-intensity walking programs showing promise for improving mobility and quality of life in early stroke patients.

Additionally, new non-invasive techniques such as transcranial magnetic stimulation and transcranial direct current stimulation are being investigated for their potential to enhance motor and language skills.

Retro Video Games: researchers in Sydney are using retro video games like “Foot Tetris” and “Space Invaders” to make rehabilitation fun and effective, helping patients with balance, cognitive reaction times, and complex stepping manoeuvres.

Wearable Robots & Devices: startups and universities are developing wearable robots and connected systems for ankle, foot, and upper limb rehabilitation. These devices, some with embedded electrodes, help retrain the brain and muscle connection by detecting muscle activation and stimulating nerves.

Neurostimulation: clinics and universities are researching non-invasive brain stimulation techniques, such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), to improve motor and language recovery after a stroke.

Your blood type plays a role in more than just transfusions. Recent research suggests it may also influence your risk of developing certain health conditions, including stroke. While it’s not the only factor that matters, understanding the connection between blood type and stroke risk can give you a clearer picture of your overall health.

People with blood type A may face a slightly higher risk of early-onset ischemic stroke. A study published in 2022 in the journal Neurology analyzed genetic data from over 16,000 stroke patients and nearly 600,000 controls. The researchers found that individuals with type A blood were 16% more likely to experience a stroke before the age of 60 compared to those with other types. One reason may involve clotting. People with type A blood tend to have higher levels of a protein called von Willebrand factor, which helps blood clot. While this is important for healing, it can also increase the risk of clot formation in blood vessels, potentially leading to a stroke.

Though type AB is the rarest blood type, some research suggests it may carry one of the highest stroke risks. A 2014 study from the University of Vermont found that individuals with type AB blood had an 83% higher risk of stroke. Furthermore, a protein known as Factor VIII, which plays a role in blood clotting, was determined to account for 60% of the association between type AB blood and stroke risk. The combination of A and B antigens as well as higher clotting factor levels may influence inflammation, vascular function, and the likelihood of blood clots, leading to a heightened stroke risk.

The evidence for blood type B and stroke is less consistent. According to a 2023 meta-analysis that examined 145,000 stroke cases and 2,000,000 controls, there is no significant association between blood type B and ischemic stroke. Other smaller studies have found mixed results, with only weak associations between blood type B and stroke risk..

If you have blood type O, the research is a bit more reassuring. Multiple studies have found that people with type O blood generally have a lower risk of developing blood clots and by extension, a lower risk of ischemic stroke. According to the 2022 study mentioned above, those with type O blood were 12% less likely to experience an early-onset stroke compared to those with other blood types. People with type O blood typically have lower levels of von Willebrand factor and factor VIII, both of which play a role in clotting. While this can lead to slower clotting in injuries, it also seems to provide some protection against unwanted clots in the arteries.

One of the more interesting findings from recent research is that the connection between blood type and stroke risk may be stronger in younger adults. The 2022 Neurology study found that the difference in stroke risk based on blood type was more pronounced in people under 60. This may be because in older adults, other factors, like high blood pressure, atrial fibrillation, and diabetes, play a more dominant role in stroke risk. In younger individuals, genetic and biological differences such as blood type may stand out more clearly.

A new research initiative aims to lay the foundation for the country’s first genetic screening programme for brain aneurysms—potentially reshaping how the NHS identifies and manages a life-threatening but often overlooked condition that can devastate families for generations.

The ROAR-DNA Project, a UK-based multicentre research project bringing together researchers from University Hospital Southampton NHS Foundation Trust (UHS) and the University of Southampton, is the first study of its kind and scale to investigate the genetic markers that may predispose people to develop brain aneurysms.

Brain aneurysms are balloon-like swellings in blood vessels of the brain, found in approximately 3 per cent of the UK population, that’s over 2 million people. While most aneurysms remain stable and harmless, around 1 in 100 will rupture, usually without warning, causing a subarachnoid haemorrhage (SAH)—a type of stroke that can be fatal or severely disabling.

In the UK, an estimated 3,000 to 5,000 people experience a brain aneurysm rupture each year, with around half of these cases proving fatal.

Most aneurysms are sporadic, meaning they are one-off events, but there is evidence of a strong genetic component to the development of intracranial (brain) aneurysms. They often run in families with over 16 per cent of patients with an aneurysm having an affected parent or sibling.

Despite this significant data, no genetic screening programme currently exists, and little is known about the genes that impact aneurysm growth and rupture.

The UK four-year ROAR-DNA Project aims to close that gap by collecting and analysing genetic data from 6,000 patients with brain aneurysms, comparing this against data from patients without brain aneurysms, working in tandem with the existing ROAR Study, which is already tracking over 20,000 patients across the NHS—the largest study of its kind globally.

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 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.

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.



We are on Facebook

ARNI