Current evidence supports digital technologies as complementary components of multidisciplinary stroke rehabilitation rather than substitutes for conventional therapy, and future research should prioritize standardized protocols, multicenter studies, long-term functional outcomes, cost-effectiveness, equitable accessibility, and greater representation of Latin American populations to advance toward evidence-based precision neurorehabilitation.
Abstract
Stroke remains a major cause of long-term neurological disability worldwide, creating a growing need for rehabilitation strategies capable of promoting functional recovery through intensive, repetitive, task-oriented, and personalized interventions. Digital neurorehabilitation has emerged as a multidisciplinary approach that integrates neuroscience, physical and rehabilitation medicine, neurology, and biomedical engineering through technologies such as virtual reality, robot-assisted rehabilitation, brain-computer interfaces, wearable sensors, artificial intelligence, and telerehabilitation. This review analyzed international scientific evidence regarding the application of these technologies after stroke, with particular attention to their relationship with experience-dependent neuroplasticity, functional outcomes, implementation challenges, and applicability across different healthcare environments, including Latin America. Scientific evidence was identified and critically synthesized from internationally recognized databases, prioritizing randomized controlled trials, systematic reviews, meta-analyses, clinical guidelines, and relevant contemporary studies. The reviewed literature showed that virtual reality and robot-assisted rehabilitation constitute the most extensively investigated technological approaches, with favorable findings particularly in upper-limb motor function, balance, gait, functional mobility, and activities of daily living. Telerehabilitation and wearable technologies provide additional opportunities for extending therapeutic continuity and objective monitoring beyond specialized rehabilitation facilities, while brain-computer interfaces and artificial intelligence represent emerging approaches for neural feedback and personalized rehabilitation. Despite these advances, considerable heterogeneity remains regarding intervention protocols, technological platforms, therapeutic intensity, outcome measures, and patient characteristics. Furthermore, acquisition costs, infrastructure requirements, professional training, accessibility, connectivity, and digital literacy continue to influence implementation, particularly in resource-constrained healthcare systems. Current evidence supports digital technologies as complementary components of multidisciplinary stroke rehabilitation rather than substitutes for conventional therapy. Future research should prioritize standardized protocols, multicenter studies, long-term functional outcomes, cost-effectiveness, equitable accessibility, and greater representation of Latin American populations to advance toward evidence-based precision neurorehabilitation.
Stroke is a leading cause of long-term neurological disability, frequently producing persistent motor impairment, loss of independence, and limitations in social participation. Virtual reality and robot-assisted rehabilitation have emerged as strategies for increasing treatment intensity, repetition, task specificity, feedback, and patient engagement. This study aimed to analyze their effectiveness in promoting neuroplasticity and improving motor and functional outcomes in adults after stroke. A structured integrative literature review based on the Scientific Method and PRISMA 2020 principles was conducted using PubMed/MEDLINE, the Cochrane Library, Scopus, Web of Science, IEEE Xplore, PEDro, and official journal databases. Twenty publications were selected, including systematic reviews, meta-analyses, randomized controlled trials, narrative reviews, and a clinical practice guideline. Ten publications were systematic reviews or meta-analyses; five presented predominantly favorable findings, four reported conditional or mixed results, and one found no clear additional benefit. Virtual reality was associated with selected improvements in upper-limb motor function, dexterity, functional independence, quality of life, cortical activation, and functional connectivity. Robot-assisted rehabilitation provided intensive and measurable movement practice and improved selected impairment-based outcomes, although its superiority over dose-matched conventional rehabilitation was inconsistent. Improvements in motor control and strength did not always translate into greater independence or spontaneous use of the affected limb in daily life. The findings indicate that digital neurorehabilitation is most effective when it provides active, repetitive, intensive, task-specific, progressively challenging, and feedback-rich training. Virtual reality and robotics should be integrated as complementary components of conventional rehabilitation rather than universal replacements. Further randomized trials with standardized protocols, equivalent treatment doses, clinically meaningful outcomes, direct neuroplasticity measurements, safety assessment, and long-term follow-up are required.
Pedro Raúl Abad Valencia, Priscilla Maria Franco Acosta, Jose Gabriel Benalcazar Game et al.· IECCMEXICO· 0 citations
Non-invasive EEG-based Brain–Computer Interface (BCI), when used alongside conventional physiotherapy and other rehabilitation approaches such as functional electrical stimulation, robotic-assisted therapy, and virtual reality, was associated with improved upper-limb motor function, motor control, functional independence, and neuroplasticity in individuals with stroke.
kumar S Anil, B. Sharvani, M. H· World Journal of Advanced Re...· 0 citations
Stroke is a major cause of disability and is frequently associated with motor impairments that limit mobility, functional independence, and the performance of activities of daily living. In this context, neuroplasticity represents an essential mechanism for recovery, enabling structural and functional adaptations of the nervous system in response to injury and therapeutic stimuli. This study aimed to analyze the influence of therapeutic exercise on the neuroplasticity mechanisms involved in motor recovery in individuals after stroke. This is a descriptive narrative literature review conducted using the PubMed/MEDLINE, SciELO, LILACS, and PEDro databases, with descriptors related to stroke, neuroplasticity, therapeutic exercise, rehabilitation, and motor recovery. Nine articles published between 2014 and 2023 in Portuguese and English were selected. The findings were organized into three thematic areas: neuroplasticity and motor recovery; therapeutic exercise as a stimulus for neuroplasticity; and the effects of exercise on post-stroke motor recovery. The studies demonstrated that repetitive, targeted motor practice adapted to individual needs may promote neural reorganization, motor learning, and functional improvements. Benefits were also observed in muscle strength, balance, gait, mobility, upper limb function, and independence in daily activities. It is concluded that therapeutic exercise represents an important strategy for stimulating neuroplastic mechanisms and promoting motor recovery after stroke. However, the heterogeneity of the protocols highlights the need for further studies to define parameters regarding the intensity, frequency, duration, and type of interventions and to guide more individualized, safe, and effective therapeutic prescriptions.
Unknown authors· International Journal of Hea...· 0 citations
Overall, the certainty of evidence was low to very low, downgraded primarily for these risk of bias concerns, severe imprecision (due to small sample sizes), and potential publication bias.
Yu Qin, Mei-xuan Li, Yan-fei Li et al.· Cochrane Database of Systema...· 0 citations
With the continuous development of artificial intelligence, novel biomaterials, and immersive technologies such as virtual reality, BCIs are expected to evolve toward more personalized, home-based, and intelligent rehabilitation solutions, accelerating their clinical application and offering new therapeutic hope for SCI patients.
Xudong Zhao, Keyi Chen, Jinquan Ma et al.· Spine Research· 0 citations
: Upper extremity dysfunction on the hemiplegic side after stroke is a common challenge in clinical rehabilitation, seriously affecting patients' quality of life. With the development of neuroscience and rehabilitation medicine, new rehabilitation technologies centered on central intervention have gradually become research hotspots. These technologies aim to reconstruct motor function by regulating cerebral cortical excitability and promoting neural plasticity. Currently, techniques such as brain-computer interface, mirror therapy, and repetitive transcranial magnetic stimulation(rTMS) have shown good potential in improving upper limb motor control, enhancing muscle strength, regulating neurotransmitters, and promoting functional balance between bilateral hemispheres. Positive progress has been achieved especially in grip strength recovery, sensory function improvement, and enhancement of activities of daily living. However, many issues remain in this field, including inconsistent intervention parameters, insufficiently elaborated mechanisms of action, lack of individualized treatment plans, and high clinical transformation difficulty of some technologies. Future research should focus on optimizing treatment parameters, developing portable devices, expanding home-based rehabilitation scenarios, and strengthening the integrated application of multimodal technologies. This article systematically examines the clinical application prospects, research progress, and efficacy characteristics of central interventional methods including technology of brain-computer interface, rTMS and mirror therapy, commencing from the pathogenesis. It aims to offer references for the practical promotion and theoretical innovation of upper extremity function rehabilitation following stroke.
He Bai· Proceedings of the 1st Inter...· 0 citations
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