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Based on recent research, the SoftHand-X offers a promising new approach to task-specific practice for stroke patients, particularly for those with severe hand impairment. Recent studies highlight its potential to reduce spasticity, improve hand function, and enhance patient participation in rehabilitation.

The SoftHand-X is a supernumerary robotic limb, which is a wearable device that augments the human body with robotic fingers. The patient’s residual, minimal active finger or wrist extension movements are used to control the device’s finger extension, while relaxing their extensor muscles controls the robotic hand’s flexion.

A 2022 pilot study published in Nature utilised the SoftHand-X to administer task-specific training (TST) to sub-acute stroke patients who lacked sufficient active finger extension to perform these tasks unaided. Patients using it showed a decrease in spasticity, with the Modified Ashworth Scale (MAS) scores improving from a baseline of 1 (mild spasticity) to 0 (no spasticity) in most patients shortly after treatment. This reduction in spasticity was also supported by electromyographic (EMG) recordings, which showed a decreased stretch reflex in the wrist and/or finger flexors.

In a usability study, patients rated the SoftHand-X as ‘well-accepted’ and ‘good’ for its usability and showed excellent participation levels; demonstrating high motivation for the intensive, goal-directed motor tasks facilitated by the device.

Another study found the SoftHand-X could partially compensate for severely impaired hand function in chronic stroke patients and reduce spasticity.

Preliminary data suggests that using other control methods, like EMG measurements from extensor muscles, could expand the number of patients who can benefit from SoftHand-X-assisted therapy.

Future research will focus on expanding the sample sise and refining control mechanisms to make the SoftHand-X accessible to a wider range of patients. These soft robotic devices represent a paradigm shift towards personalised, accessible, and engaging neurorehabilitation, with the potential to improve recovery outcomes and quality of life for stroke survivors.

Ref for you: Trompetto, C., Catalano, M.G., Farina, A. et al. A soft supernumerary hand for rehabilitation in sub-acute stroke: a pilot study. Sci Rep 12, 21504 (2022).

Post-stroke rehabilitation is a critical, multi-stage process, yet many survivors report feeling unsupported after formal, short-term hospital therapy ends. This can lead to decreased motivation, learned non-use of affected limbs, and a heightened fear of falling, which can all negatively impact long-term recovery.

The Action for Rehabilitation from Neurological Injury (ARNI) Institute was founded to address this significant gap in the patient pathway. ARNI offers an exciting, innovative, evidence-based program that supports stroke survivors in taking charge of their long-term recovery. The ARNI Approach is distinguished by its focus on three core principles:

* Functional Task-Related Practice: Moving beyond passive treatment, ARNI engages survivors in repetitive, meaningful activities designed to retrain the brain and body. This leverages the brain’s neuroplasticity… its ability to reorganise itself…to recover lost skills.
* Physical Coping Strategies: ARNI instructors teach specific, practical techniques for managing daily life challenges, such as getting up from the floor safely with one-sided weakness. This builds physical resilience and confidence.

* Stroke-Specific Resistance Training: Incorporating strength and conditioning exercises adapted for neurological limitations helps build stability and strength, empowering survivors to discard assistive devices and enhance their functional independence.

Implications for Clinical Practice & Research: The ARNI model challenges the traditional paradigm that recovery plateaus shortly after hospital discharge. Its success highlights the value of personalised, intensive, and long-term neurorehabilitation strategies. For clinicians and researchers, ARNI’s integration of psychological support, functional training, and strength conditioning offers a powerful framework for enhancing patient outcomes and promoting self-reliance.

A wave of systematic reviews and randomised controlled trials  over the last few years has refined our understanding, confirming task-specific training (TST)’s efficacy while also shedding light on critical factors like intensity and technological integration.

Task-specific training involves repetitive, goal-directed practice of real-world functional tasks, such as grasping a cup or buttoning a shirt, rather than isolated, non-functional exercises. By promoting active problem-solving and engaging neural pathways in a meaningful context, TST harnesses the brain’s plasticity to maximise motor recovery.

A recent systematic review in The American Journal of Occupational Therapy synthesised findings from 16 studies involving nearly 700 stroke survivors. The review found strong evidence supporting activity-based TST for improving UL motor function, motor performance, and activities of daily living (ADLs). and a May 2025 study in Clinical Rehabilitation found task-oriented training produced statistically and clinically meaningful improvements in UL function for patients with subacute stroke compared to conventional exercise programmes.

The latest research is also exploring ways to amplify the effects of TST by combining it with cutting-edge techniques; a 2023 network meta-analysis found that combining TST with electrical stimulation is a promising approach for improving UL motor function, especially for individuals within six months of stroke onset.

Interestingly, a group of newer studies are examining dual-task training (DTT), where individuals practice a task while performing a secondary activity. Preliminary results from a May 2025 study suggest DTT can effectively improve UL function and trunk performance in chronic stroke patients.

ARNI says that the evidence for task-specific training in stroke rehabilitation is undeniable. Recent research provides new avenues for enhancing its effects through technology and combination therapies. The message is clear for us stroke survivors: focusing on repetitive, meaningful, real-world tasks is a highly effective strategy for regaining a handle on life after stroke.

Recent research highlights significant progress in treating post-stroke vascular dementia (PSVD), moving beyond symptomatic management toward novel, targeted interventions. A multimodal approach is emerging as the most promising strategy, combining pharmacotherapy, brain stimulation, and comprehensive lifestyle interventions to address the complex pathology of PSVD.

Key research advances:

  • Repurposing cardiovascular drugs: Phase 2 trials have shown that the combination of isosorbide mononitrate and cilostasol, used for other cardiovascular issues, significantly improves cognitive outcomes and reduces dependency in patients following a lacunar stroke.
  • Targeting vascular mechanisms: Early-stage research is exploring drugs that specifically target endothelial dysfunction, the breakdown of the blood-brain barrier, and impaired waste clearance via the glymphatic system. Agents like the soluble guanylyl cyclase stimulator CY6463 and the existing blood pressure medication amlodipine are under investigation for their potential to restore cerebral blood flow and prevent cognitive decline.
  • Non-invasive brain stimulation: Systematic reviews indicate that non-invasive techniques like transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS) show significant and consistent benefits for cognitive function in stroke survivors. Early intervention within three months post-stroke is associated with the most reliable outcomes.
  • Lifestyle modifications: Evidence-based lifestyle changes are crucial for managing PSVD. Research supports the benefits of aerobic and strength training, adherence to diets like the MIND diet, and control of comorbidities such as hypertension, diabetes, and hyperlipidemia to slow cognitive decline.
  • Emerging therapies: Investigational areas include stem-cell therapy and the modulation of the gut microbiome, though more research is needed to establish their safety and efficacy.

An effective strategy for PSVD requires a personalised, multidisciplinary approach that integrates the following components:

  1. Early and aggressive risk factor management: Controlling blood pressure, cholesterol, and diabetes is essential to prevent further vascular damage.
  2. Targeted rehabilitation: Incorporating cognitive training alongside promising neuro-modulation techniques like tDCS.
  3. Comprehensive support: Addressing mood disorders, such as anxiety and depression, with psychotherapy and pharmacotherapy is critical for overall well-being.

While there is no cure for PSVD, advances in research are providing new hope. The field is moving toward interventions that actively repair vascular and neural damage rather than simply managing symptoms. Further research is necessary, particularly with larger clinical trials, to confirm the efficacy and long-term benefits of these novel therapies.

A stroke can have a profound impact on a person’s cognitive abilities, affecting memory, attention, executive functions, and processing speed. While cognitive impairment can limit daily independence and reduce quality of life, recent advances in cognitive rehabilitation are offering new hope to survivors. By harnessing the power of neuroplasticity; the brain’s ability to reorganise itself… rehabilitation is moving beyond traditional paper-and-pencil exercises towards a more intensive, personalised, and technology-driven approach. At its core, cognitive rehabilitation is based on two complementary approaches: restorative and compensatory.

  • Restorative approaches aim to repair or restore a damaged cognitive function. These techniques often involve repetitive, focused training to stimulate and reorganise neural pathways affected by the stroke.
  • Compensatory approaches focus on teaching new strategies and skills to help a person work around their cognitive deficits. This might involve using external aids like memory notebooks or technology to manage daily life.

Digital technologies are now playing a central role in delivering cognitive rehabilitation, offering engaging, interactive, and data-driven therapies.

  • Computer-assisted cognitive training (CACT): Software platforms, like BrainHQ and RehaCom, provide structured, game-like exercises that target multiple cognitive domains, including attention, working memory, and processing speed. A recent meta-analysis found that CACT was significantly more effective than conventional methods for improving general cognitive function as measured by the Montreal Cognitive Assessment (MoCA), which heavily emphasises executive function.
  • Virtual Reality (VR) and gamification: VR offers a safe, simulated environment for stroke survivors to practice real-world tasks, such as shopping or managing finances. The immersive nature of VR can increase patient motivation and engagement, which is critical for driving neuroplastic change. Studies suggest VR can be more effective than conventional training for improving overall cognitive function, attention, and executive function.
  • Telerehabilitation: Using technology to provide rehabilitation remotely is increasing access and allowing for higher doses of therapy in the home or community. This is particularly valuable for patients facing challenges with transport or access to high-quality rehabilitation centres.

Increasingly, researchers are exploring how to combine different types of therapies to maximise recovery.

  • Exercise and cognitive training: Combining physical activity, such as aerobic exercise, with cognitive training appears to enhance global cognitive function and memory. Exercise increases cerebral blood flow and levels of neurotrophins, such as brain-derived neurotrophic factor (BDNF), which promotes neuronal survival and plasticity.
  • Brain stimulation: Non-invasive brain stimulation techniques, like transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), can be used alongside traditional therapies to modulate cortical excitability and promote neuroplasticity. While the evidence is still evolving, some studies suggest that NIBS can enhance the effects of therapy, particularly for neglect and language deficits.
  • Integrated cognitive-behavioral training: Recent research highlights the benefits of integrating cognitive training with behavioral strategies. A study in chronic stroke patients found that adding a computer-based cognitive-behavioral training program to a physical therapy regimen significantly enhanced cortical reorganisation and improved performance in memory, attention, and logical reasoning.

While promising, the field of cognitive rehabilitation still faces challenges, including the heterogeneity of stroke and the need for larger, high-quality clinical trials. However, several trends point towards a more effective future:

  • Personalised, biomarker-driven care: Tailoring interventions to the individual patient, guided by biomarkers and neuroimaging, could optimise outcomes.
  • Multidisciplinary collaboration: Optimising recovery requires seamless cooperation between neurologists, rehabilitation specialists, engineers, and technology developers.
  • Leveraging motivation: Designing rehabilitation around engaging, gamified, and ecologically valid tasks can increase patient motivation and adherence, which are key drivers of neuroplasticity.

The field of stroke aphasia is witnessing a new wave of developments, pushing beyond traditional speech and language therapy (SLT) toward technologically enhanced and personalised care. Recent news and academic publications from 2025 highlight significant advancements in digital health, novel surgical techniques, and interdisciplinary care models aimed at improving long-term outcomes and quality of life for stroke survivors.

For example, new research, including a randomised controlled trial published in March 2025, shows that generative AI chatbots can effectively support the emotional well-being of neuro-rehabilitation patients. For stroke survivors, these AI companions can monitor subtle changes in mood and communication patterns between therapy sessions, helping to detect early signs of depression and anxiety.

Technology-supported aphasia therapies delivered via computers, tablets, or virtual reality (VR) continue to offer new avenues for intensive, long-term care. The Big CACTUS trial confirmed the superiority of self-managed, computerized SLT over usual care for chronic aphasia. Similarly, the online virtual environment “EVA PARK uses a fantasy island context to provide engaging, real-life communication scenarios. In acute stroke care, AI software is being used to interpret brain scans more rapidly. Early analysis from NHS England suggests this can reduce the time to treatment by over an hour, potentially tripling a patient’s chances of a full recovery.

A clinical trial published in The BMJ in June 2025 has demonstrated the effectiveness of combining a type of neck surgery (C7 neurotomy) with intensive SLT for patients with chronic post-stroke aphasia and arm spasticity. Patients receiving both treatments showed greater improvement in communication abilities than those who received SLT alone.

The European Stroke Organisation (ESO) guidelines, published in May 2025, reinforce the importance of intensive and frequent SLT. It recommends at least 20 hours of therapy, four or more days per week, and notes that digital or group therapy can augment traditional one-on-one sessions.

Further research reinforces the critical need for better long-term support for stroke survivors, particularly for non-motor complications like fatigue, sleep disturbance, and depression. These issues are often under-recognised and under-treated but can significantly impact recovery and quality of life. These recent developments demonstrate a shift toward more integrated, personalised, and technology-assisted approaches in stroke aphasia care.

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.



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