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Rehabilitation and Management of Stroke
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Rehabilitation and Management of Stroke

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Rehabilitation".

Deadline for manuscript submissions: 25 September 2025 | Viewed by 3414

Special Issue Editor

Prof. Dr. Thomas Platz

E-Mail Website
Guest Editor
1. BDH-Klinik Greifswald, Institute for Neurorehabilitation and Evidence-based Practice, "An-Institut" University of Greifswald, Karl-Liebknecht-Ring 26a, D-17491 Greifswald, Germany
2. Neurorehabilitation Research Group, Universitätsmedizin Greifswald, Greifswald, Germany
Interests: neurology; neurorehabilitation; stroke; epidemiology; stroke rehabilitation; motor learning; rehabilitation

Special Issue Information

Dear Colleagues,

Globally, stroke is the second-leading cause of death and the third-leading cause of death and disability combined. While the age-standardized rates of stroke have decreased, the absolute number of incident strokes, prevalent strokes, deaths from stroke, and stroke-related disability have all increased substantially over the last several decades and are predicted to increase further in the years to come.

At the same time, organized stroke rehabilitation, provided by multi-disciplinary teams that manage stroke survivors, is substantially improving functional outcomes and reducing stroke-related disability. Team members aim to provide coordinated multi-disciplinary care, using standard approaches, to manage common post-stroke problems.

The brain is sub-serving, so there are many different functions that all need to be considered when it comes to neurorehabilitation in people with brain damage and related neuro-disabilities after stroke. Our rehabilitation services and interventions must fully cover these aspects. Specific and intensive target training for affected brain functions, i.e., “neural repair therapy”, offers a chance of improving impairment and function over extended periods following stroke, with a heightened background of endogenous plasticity in the first months. At the same time, a structured “continuum of care” approach is necessary to serve all the needs of stroke survivors in the long term.

In this context, clinical decision making is best informed by neuroscientifically grounded evidence from clinical trials with adequate populations, clinically applicable interventions, relevant comparisons, and clinically relevant outcomes (PICO).

When it comes to implementation, regions, countries, and healthcare facilities must identify priorities, develop a comprehensive strategic plan, and establish monitoring and evaluation mechanisms for stroke rehabilitation, to promote effective and efficient services.

Therefore, in this Special Issue, we encourage researchers to submit original papers and focused reviews on the topic of “Rehabilitation and Management in Stroke”. Papers that could inform clinical decision making and service implementation are particularly welcome, including reviews of effectiveness, RCTs of stroke rehabilitation interventions, comprehensive reviews on implementation science, and research papers in the field of stroke rehabilitation.

Prof. Dr. Thomas Platz
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • stroke
  • rehabilitation
  • evidence
  • implementation
  • neurology
  • neurorehabilitation

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Published Papers (3 papers)

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14 pages, 246 KiB  
Article
Evaluation of the Prevalence of Sleep Disorders and Their Association with Stroke: A Hospital-Based Retrospective Study
by Majed Mohammad Alabdali, Abdulrahim Saleh Alrasheed, Faynan Sultan Alsamih, Reenad Fahad Almohaish, Jumana Nasser Al Hadad, Noor Mohammad AlMohish, Omar Ali AlGhamdi, Suliman Khalid Alabdulaali and Zainab Ibrahim Alabdi
J. Clin. Med. 2025, 14(4), 1313; https://doi.org/10.3390/jcm14041313 - 16 Feb 2025
Viewed by 827
Abstract
Background: Sleep disturbances are prevalent among stroke survivors, significantly impacting their recovery and quality of life. This study aimed to evaluate the prevalence of sleep disorders, sleep quality, risk of obstructive sleep apnea (OSA), and daytime sleepiness among stroke survivors and to identify [...] Read more.
Background: Sleep disturbances are prevalent among stroke survivors, significantly impacting their recovery and quality of life. This study aimed to evaluate the prevalence of sleep disorders, sleep quality, risk of obstructive sleep apnea (OSA), and daytime sleepiness among stroke survivors and to identify potential associations with clinical and demographic factors. Materials and Methods: A retrospective observational study analyzed adult stroke survivors (aged ≥ 18 years) attending neurology clinics at our institution from November 2022 to November 2024. The primary outcome measures included overall sleep quality, sleep apnea and daytime sleepiness assessment. Data were collected using validated Arabic versions of the Pittsburgh Sleep Quality Index (PSQI), STOP-Bang Questionnaire, and Epworth Sleepiness Scale (ESS). Statistical analyses, including Chi-square tests and t-tests, were performed using SPSS version 30.1. Results: A total of 100 stroke survivors, mostly aged 40–60 years, were recruited in our study. The prevalence of sleep disorders was 60.0%, with poor sleep quality reflected by a mean global PSQI score of 9.13 ± 14.40. Additionally, 19.0% were at high risk of OSA, and 24.0% experienced abnormal daytime sleepiness. While no statistically significant associations were found between sleep disorders and clinical or demographic factors, trends indicated higher sleep disorder prevalence in those with hemorrhagic stroke and high-risk OSA profiles. Conclusions: Our study highlights a high prevalence of sleep disorders among stroke survivors, emphasizing the need for regular sleep assessments. Future studies should explore objective assessments and larger sample sizes to validate these findings and to assess their potential implication in stroke recovery and quality of life. Full article
(This article belongs to the Special Issue Rehabilitation and Management of Stroke)
20 pages, 279 KiB  
Article
Effects of Intensive Impairment-Oriented Arm Rehabilitation for Chronic Stroke Survivors: An Observational Cohort Study
by Thomas Platz, Katharina Kaiser, Tina Laborn and Michael Laborn
J. Clin. Med. 2025, 14(1), 176; https://doi.org/10.3390/jcm14010176 - 31 Dec 2024
Viewed by 843
Abstract
Objective: To assess the effects of a two-week course of intensive impairment-oriented arm rehabilitation for chronic stroke survivors on motor function. Methods: An observational cohort study that enrolled chronic stroke survivors (≥6 months after stroke) with mild to severe arm paresis, [...] Read more.
Objective: To assess the effects of a two-week course of intensive impairment-oriented arm rehabilitation for chronic stroke survivors on motor function. Methods: An observational cohort study that enrolled chronic stroke survivors (≥6 months after stroke) with mild to severe arm paresis, who received a two-week course of impairment-oriented and technology-supported arm rehabilitation (1:1 participant–therapist setting), which was carried out daily (five days a week) for four hours. The outcome measures were as follows: the primary outcome was the arm motor function of the affected arm (mild paresis: BBT, NHPT; severe paresis: Fugl-Meyer arm motor score). The secondary outcomes were measures of finger strength, active ROM, spasticity, joint mobility/pain, somatosensation, emotional distress, quality of life, acceptability, and adverse events. Results: One hundred chronic stroke survivors (≥6 months after stroke) with mild to severe arm paresis were recruited. The training was acceptable (drop-out rate 3%; 3/100). The clinical assessment indicated improved motor function (SMD 0.42, 95% CI 0.36–0.49; n = 97), reduced spasticity/resistance to passive movement, and slightly improved joint mobility/pain and somatosensation. The technology-based objective measures corroborated the improved active range of motion for arm and finger joints, reduced finger spasticity/resistance to passive movement, and the increased amount of use in daily life, but there was no effect on finger strength. The patient’s emotional well-being and quality of life were positively influenced. Adverse events were reported by the majority of participants (51%, 49/97) and were mild. Conclusions: Structured intensive impairment-oriented and technology-supported arm rehabilitation can promote motor function among chronic stroke survivors with mild to severe arm paresis and is an acceptable and tolerable form of treatment when supervised and adjusted by therapists. Full article
(This article belongs to the Special Issue Rehabilitation and Management of Stroke)

Other

Jump to: Research

24 pages, 3271 KiB  
Systematic Review
Immersive Virtual Reality in Stroke Rehabilitation: A Systematic Review and Meta-Analysis of Its Efficacy in Upper Limb Recovery
by Chala Diriba Kenea, Teklu Gemechu Abessa, Dheeraj Lamba and Bruno Bonnechère
J. Clin. Med. 2025, 14(6), 1783; https://doi.org/10.3390/jcm14061783 - 7 Mar 2025
Viewed by 1238
Abstract
Background: Immersive virtual reality (imVR) has shown promise for upper limb stroke rehabilitation (ULSR). However, optimal implementation and treatment modalities remain unclear. This systematic review and meta-analysis aimed to evaluate imVR’s efficacy in ULSR and determine optimal treatment parameters. Methods: A [...] Read more.
Background: Immersive virtual reality (imVR) has shown promise for upper limb stroke rehabilitation (ULSR). However, optimal implementation and treatment modalities remain unclear. This systematic review and meta-analysis aimed to evaluate imVR’s efficacy in ULSR and determine optimal treatment parameters. Methods: A systematic review and meta-analysis of randomized controlled trials (RCTs), comparing imVR to conventional rehabilitation (CR) in adult stroke patients, was conducted. Databases including, the Web of Science, Scopus, and PubMed, were searched. Meta-regression further explored the relationship between intervention duration, frequency, and outcomes. Results: Twenty-three studies were included in the systematic review, representing 395 patients, with thirteen incorporated into the meta-analysis. imVR showed statistically significant improvements in the Fugl–Meyer Assessment Upper Extremity (FMA-UE) Scale (mean difference (MD) = 3.04, 95% CI [1.46; 4.62], p < 0.001) and the Box and Block Test (BBT) (MD = 2.85, 95% CI [0.70; 4.99], p = 0.009) compared to CR, but not in the Action Research Arm Test (ARAT) (MD = 3.47, 95% CI [−0.22; 7.15], p = 0.06). However, these improvements did not reach clinically significant thresholds (7 points for FMA-UE and 6 points for BBT). Clinical subgroup analysis showed significant improvements for both subacute (standardized mean difference (SMD) = 0.92, 95% CI [0.48; 1.36], p = 0.002) and chronic (SMD = 0.69, 95% CI [0.03; 1.35], p = 0.03) stroke stages. Meta-regression indicated that there was a significant positive relationship between the intervention duration and upper limb improvement. Conclusions: imVR demonstrates potential for improving upper limb motor function following stroke, particularly with longer intervention durations and individual session lengths for chronic stroke. However, the improvements observed were not clinically significant, highlighting the need for further research with larger sample sizes and standardized outcome measures to determine optimal treatment protocols. Full article
(This article belongs to the Special Issue Rehabilitation and Management of Stroke)
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