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Recent data from the NHS reveals a worrying and significant trend in cardiovascular health: a 28% increase in hospital admissions for stroke over the last two decades. While advances in care have improved survival rates, the sheer volume of cases is putting immense pressure on healthcare systems and signalling deeper public health issues that demand our attention.

Admissions surged from 87,069 in 2004/05 to 111,137 in 2023/24. Part of this is due to an aging population, but significant spikes are occurring in younger cohorts. The highest increase was a staggering 55% among those aged 50-59, underscoring that stroke is not just a risk for the elderly. Lifestyle factors like obesity, poor diet, and lack of exercise are contributing to this growing burden on cardiovascular health.

Stroke is basically an ever-growing public health crisis impacting people at younger ages.  These findings serve as a critical wake-up call for a renewed focus on primary prevention; ARNI notes that we must move beyond just treating the aftermath of a stroke and address the root causes driving this trend. It’s a shared responsibility of healthcare professionals, policymakers… and the public too… to take proactive steps to address the underlying causes and mitigate this alarming trend.

In Scotland, The Sir Jules Thorn Centre for Co-Creation of Rehabilitation Technology, located at the Wolfson Centre at the University of Strathclyde in Glasgow, is helping stroke survivors with leading-edge, tech-enriched retraining programmes to help them regain independence. The centre is a partnership between the University, NHS Lanarkshire, and the charity Chest Heart & Stroke Scotland. Its mission is to make intensive, technology-enriched rehabilitation more accessible to stroke survivors, helping them regain independence and hope.

Rehab exercises can sometimes feel repetitive, but the Sir Jules Thorn Centre is making them fun and engaging. They adapt controllers and use computer games to help survivors recover dexterity in their hands and arms. As one survivor put it, the machines are ‘rigged to computer games and they work you hard, but also make it interesting and fun’. This playful approach keeps motivation high, encouraging people to push themselves further.

For survivors with walking difficulties, a high-tech treadmill with a harness system provides crucial support and feedback. The technology uses cameras to track movement, allowing patients to see exactly how they walk and make corrections in real time. This real-time visual feedback, often within virtual reality environments, is not only supportive but also highly motivating, boosting confidence with every step.

With the help of advanced technology, patients can achieve a level of intensive, tailored rehab that isn’t possible with traditional methods alone. The centre’s eight-week programme is designed to push patients toward their goals, whether it’s recovering the ability to walk and talk at the same time or achieving a small but hugely significant personal goal like zipping up a jacket. This personalised attention is making a massive difference.

They work directly with stroke survivors, clinicians, and engineers to develop technologies that are genuinely useful and user-friendly. By involving the people who will use the technology, they ensure the solutions are truly patient-centred and address real-world challenges.

In prototype form at the moment, the tech from researchers at the Harvard John A. Paulson School of Engineering and Applied Sciences and the Wyss Institute may possibly transform upper-limb rehabilitation potential for stroke survivors by offering several key advantages over their rigid counterparts.

Instead of a bulky, mechanical frame, the new device, named ‘Reachable’, is a comfortable, sensor-loaded vest with an inflatable bladder under the arm. This design is less restrictive, more portable, and can be worn for longer durations, which is critical for intensive, repetitive therapy needed for motor recovery.

The Reachable device utilises a combination of a physics-based model and a machine learning algorithm to tailor assistance to each individual’s unique movement patterns. The system tracks movement and pressure with sensors and uses this data to learn the user’s intent. By doing so, the robot provides assistance that feels more natural and intuitive.

In testing, the device demonstrated the ability to distinguish a user’s intended shoulder movements with high accuracy. It effectively reduced the amount of force needed to lower an arm by about a third and users showed larger, more efficient ranges of motion in their shoulders, elbows, and wrists, reducing the need for compensatory movements like body leaning.

A major strength of the Harvard research is its strong emphasis on user feedback. Patients with stroke and ALS were involved in testing and development from the early stages, ensuring that the final device is not only clinically effective but also comfortable and easy to use. This patient-centered approach was highlighted by one volunteer who noted feeling engaged in the process rather than feeling like a ‘lab rat’. This feedback loop was instrumental in refining the design for better aesthetics and wearability, which are vital for real-world adoption.

The development of this lightweight, wearable technology holds significant promise for home-based rehabilitation. Many stroke survivors face challenges accessing consistent in-clinic therapy due to cost and travel. A portable device like Reachable could allow patients to perform therapeutic exercises more frequently and regain independence in their daily lives, from eating and drinking to other routine tasks. Researchers have secured grants to further test the device with users in their homes, a crucial step toward commercialisation.

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).

* 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.

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.