News

Arm and hand weakness is a debilitating and common consequence for a large number of stroke survivors and ARNI recognises that conventional rehab often struggles to provide the necessary intensity and engagement required to maximise the brain’s neuroplasticity.

To address this problem, a team of researchers at Queen’s University Belfast’s School of Psychology, led by neuroscientist Dr. Kathy Ruddy, is conducting a new clinical trial that combines Brain-Computer Interface (BCI) technology with computer gaming to stimulate arm movement and function. This one-year project, funded by Northern Ireland Chest, Heart and Stroke (NICHS), represents a novel and potentially game-changing approach to stroke recovery.

The Queen’s University trial centres on the concept of motor imagery; research has shown that merely thinking about a movement activates the same neural pathways in the motor cortex as physically performing the action.

In the QUB trial, participants wear a simple, non-invasive BCI headset that reads their brain activity. As the stroke survivor imagines moving their affected arm, the headset detects the corresponding brain signals and these signals are then translated to control a computer game, creating a powerful biofeedback loop. This technique serves to reinforce neural pathways by repeatedly activating the motor cortex through imagined movement, allowing people with significant motor impairment to still ‘practice’ moving their arm… thereby strengthening spared neural connections/preventing from becoming dormant due to lack of use.

The trial aims to recruit 50 stroke survivors from Northern Ireland to test the efficacy of this BCI-gaming system; please contact the Queen’s University research team directly if this is of interest to you. The QUB website has a news page with contact information for the School of Psychology and research staff.

New research just presented at the European Society of Cardiology congress reveals a worrying link between air pollution and an increased risk of stroke for millions of us in the country.

A decade-long study of nearly 300,000 people found that those living in the most polluted areas of the UK were 7% more likely to suffer a stroke compared to those in areas with cleaner air. The same study also found an increased risk of heart failure. The team assessed the air pollution exposure of more than 318,000 people living in the UK. This was based on air pollution monitoring carried out by separate researchers between January 2010 and 2011 within 100 square metres of the participants’ homes.

The participants, aged 40 to 69 at the start of the research, were taking part in the UK Biobank study. They had no history of a stroke or mini-stroke, defined as a temporary disruption to the brain’s blood supply, ischemic heart disease – cardiovascular complications caused by narrowing of the heart’s arteries, or cancer. This is a stark reminder that the air we breathe has a profound effect on our health, particularly our cardiovascular system. The fine particulate matter PM2.5 (which measures less than 2.5 micrometres in diameter,) comes from vehicle exhaust and other sources.  It can enter the bloodstream and cause inflammation and blood vessel damage, increasing the risk of cardiovascular events.

Over an average 12-year follow-up period, 5967 of the participants had a stroke, 2985 developed cardiovascular disease and 1020 people died due to any cause. After accounting for other factors that can influence stroke risk, such as physical fitness levels, the researchers found that every 5 microgram per cubic metre (µg/m3) increase in fine particulate matter (PM2.5) that the participants were exposed to across a year was linked to a 24 per cent rise in their risk of a stroke.

The British Heart Foundation and other organisations are calling for stricter air quality targets; let’s work together for cleaner air and reduction in strokes!

For stroke survivors worldwide, persistent upper limb impairment is a significant and often devastating consequence. While intensive, repetitive therapy is crucial for activating neuroplasticity and improving motor function, access to high-intensity, round-the-clock rehab is often unfeasible in traditional clinical settings. We know that this gap between formal therapy and the need for continual muscle engagement can lead to suboptimal recovery, particularly for those with moderate-to-severe impairment.

Addressing this challenge, KnitRegen, a UK-based MedTech startup, is developing a novel wearable smart textile system designed to facilitate constant, functional rehabilitation. Founded as a spin-out from the Royal College of Art, KnitRegen leverages a unique combination of technical textile design, neuroscience, and material science. In collab with researchers and organisations like the University of Central Lancashire and the Centre for Process Innovation, the company has developed a prototype wristband device, dubbed the ‘PowerBead’. This device delivers targeted muscle stimulation through integrated smart textile components, moving the technology from a bulky, backpack-sized system to a discreet, user-friendly wearable. The innovation is based on evidence that delivering specific, timed muscle stimulation can improve strength and mobility, especially when paired with an auditory cue.

The KnitRegen system aims to provide continual muscle stimulation outside of supervised therapy sessions, a critical factor for driving neuroplasticity. The mechanism is thought to involve stimulating the recruitment of the reticulospinal tract (RST), offering a potential pathway for recovery for survivors with severe damage to the corticospinal tract (CST). By enabling consistent muscle stimulation, the device increases the total amount of therapeutic engagement, which is linked to improved recovery outcomes, particularly for survivors with moderate-to-severe upper limb impairments (a patient group that often has limited treatment options).

The embedded smart textile components provide state-of-the-art muscle stimulation, specifically activating muscles in the hand and arms to restore movement and strength. Developed in co-design with stroke survivors, the wristband is designed for comfort and ease of use, addressing a common usability challenge with existing functional electrical stimulation (FES) systems. It’s also designed to be discreet, resembling a normal accessory rather than an obvious medical device.

Initial studies involving 16 stroke survivors have shown that the PowerBead can effectively activate hand and arm muscles. Further pilot studies on healthy volunteers have been conducted to optimise the wearable’s comfort and effectiveness. The company plans to conduct longer-term trials to measure the device’s effect on strength and movement over time and is working towards gaining regulatory approval. KnitRegen’s data collection could also contribute valuable information on continual rehabilitation methods for other Internet of Things (IoT) devices in the future.

The KnitRegen smart textile system represents a significant step forward in making intensive, evidence-based rehab accessible for stroke survivors at home but like the VTS Glove below, it’s not on the market yet. The PowerBead is still undergoing further development and clinical testing, but it seems to offer a potential breakthrough for millions of stroke survivors worldwide who are seeking to regain movement and independence…

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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