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Medicina
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New Advances in Acute Stroke Rehabilitation
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New Advances in Acute Stroke Rehabilitation

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Neurology".

Deadline for manuscript submissions: 28 February 2026 | Viewed by 5496

Special Issue Editor

Dr. Jong Bae Choi

E-Mail Website
Guest Editor
Department of Occupational Therapy, Chosun University, 309 Pilmun-daero, Dong-gu, Gwangju 61452, Republic of Korea
Interests: stroke rehabilitation; robotic rehabilitation; virtual reality; telerehabilitation; neurorehabilitation; transcranial magnetic stimulation (TMS); dysphasia; gait; mirror therapy; postural balance; upper limb function; occupational therapy; physical therapy

Special Issue Information

Dear Colleagues,

Despite scientific advancements and the advancement of various medical technologies, the number of patients with stroke, a representative central nervous system disease, is increasing worldwide every year. This increase is due to the rapid aging of the population, which has become a problem not only for individuals and families, but also for society as a whole. Therefore, many studies have shown for a long time that early rehabilitation is an important factor in the recovery process. Nowadays, new technologies have been incorporated into the field of rehabilitation to improve the effectiveness of various therapeutic interventions strategies. Recently, new intervention methods such as robotic rehabilitation, virtual reality, telerehabilitation, motor imagery training, transcranial magnetic stimulation (TMS), mirror therapy, and kinesio taping, for which many studies are being conducted, are providing scientific evidence through single or parallel interventions.

Correlation between stroke lesions and clinical features and outcomes provides the basis for personalized neurorehabilitation, a promising perspective to account for differences in individual responses to treatment and improve quality of care. Defining new approaches and the most appropriate timing for acute and chronic phases of neurological diseases will play an important role in optimizing neurological rehabilitation interventions.

The scope of this special issue and the types of contributions we request are to integrate research activities on innovative technologies for the assessment and treatment of stroke rehabilitation and the latest advances in overall neurorehabilitation, including upper extremity function, gait, dysphagia, cognitive function, and activities of daily living.

Dr. Jong Bae Choi
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. Medicina is an international peer-reviewed open access monthly 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 2200 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
  • robotic rehabilitation
  • virtual reality
  • telerehabilitation
  • motor imagery training
  • transcranial magnetic stimulation (TMS)
  • swallowing rehabillitation
  • gait
  • mirror therapy
  • kinesio taping
  • upper limb function

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Published Papers (3 papers)

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Research

16 pages, 898 KiB  
Article
Integrating Brain-Computer Interface Systems into Occupational Therapy for Enhanced Independence of Stroke Patients: An Observational Study
by Erika Endzelytė, Daiva Petruševičienė, Raimondas Kubilius, Sigitas Mingaila, Jolita Rapolienė and Inesa Rimdeikienė
Medicina 2025, 61(5), 932; https://doi.org/10.3390/medicina61050932 - 21 May 2025
Viewed by 834
Abstract
Background and Objectives: Brain-computer interface (BCI) technology is revolutionizing stroke rehabilitation by offering innovative neuroengineering solutions to address neurological deficits. By bypassing peripheral nerves and muscles, BCIs enable individuals with severe motor impairments to communicate their intentions directly through control signals derived [...] Read more.
Background and Objectives: Brain-computer interface (BCI) technology is revolutionizing stroke rehabilitation by offering innovative neuroengineering solutions to address neurological deficits. By bypassing peripheral nerves and muscles, BCIs enable individuals with severe motor impairments to communicate their intentions directly through control signals derived from brain activity, opening new pathways for recovery and improving the quality of life. The aim of this study was to explore the beneficial effects of BCI system-based interventions on upper limb motor function and performance of activities of daily living (ADL) in stroke patients. We hypothesized that integrating BCI into occupational therapy would result in measurable improvements in hand strength, dexterity, independence in daily activities, and cognitive function compared to baseline. Materials and Methods: An observational study was conducted on 56 patients with subacute stroke. All patients received standard medical care and rehabilitation for 54 days, as part of the comprehensive treatment protocol. Patients underwent BCI training 2–3 times a week instead of some occupational therapy sessions, with each patient completing 15 sessions of BCI-based recoveriX treatment during rehabilitation. The occupational therapy program included bilateral exercises, grip-strengthening activities, fine motor/coordination tasks, tactile discrimination exercises, proprioceptive training, and mirror therapy to enhance motor recovery through visual feedback. Participants received ADL-related training aimed at improving their functional independence in everyday activities. Routine occupational therapy was provided five times a week for 50 min per session. Upper extremity function was evaluated using the Box and Block Test (BBT), Nine-Hole Peg Test (9HPT), and dynamometry to assess gross manual dexterity, fine motor skills, and grip strength. Independence in daily living was assessed using the Functional Independence Measure (FIM). Results: Statistically significant improvements were observed across all the outcome measures (p < 0.001). The strength of the stroke-affected hand improved from 5.0 kg to 6.7 kg, and that of the unaffected hand improved from 29.7 kg to 40.0 kg. Functional independence increased notably, with the FIM scores rising from 43.0 to 83.5. Cognitive function also improved, with MMSE scores increasing from 22.0 to 26.0. The effect sizes ranged from moderate to large, indicating clinically meaningful benefits. Conclusions: This study suggests that BCI-based occupational therapy interventions effectively improve upper extremity motor function and daily functions and have a positive impact on the cognition of patients with subacute stroke. Full article
(This article belongs to the Special Issue New Advances in Acute Stroke Rehabilitation)
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9 pages, 666 KiB  
Article
Effect of Sarcopenia on Functional Recovery in Acute Stroke Patients Admitted for Standard Rehabilitation Program
by So-Yeong Kim, Woon-Su Cho, Chi-Bok Park and Byeong-Geun Kim
Medicina 2024, 60(10), 1716; https://doi.org/10.3390/medicina60101716 - 20 Oct 2024
Cited by 3 | Viewed by 1998
Abstract
Background and Objectives: Sarcopenia is a significant concern in stroke rehabilitation, with a high prevalence reported in acute stroke patients. This study examines the effect of sarcopenia on rehabilitation outcomes in acute stroke patients. Materials and Methods: This study was conducted [...] Read more.
Background and Objectives: Sarcopenia is a significant concern in stroke rehabilitation, with a high prevalence reported in acute stroke patients. This study examines the effect of sarcopenia on rehabilitation outcomes in acute stroke patients. Materials and Methods: This study was conducted with acute stroke patients admitted within 90 days of onset to the rehabilitation hospital. Participants were divided into a stroke with sarcopenia group and a stroke without sarcopenia group. Evaluations were conducted at baseline, 4 weeks, and 8 weeks, including the following assessments: manual muscle testing (MMT), Berg Balance Scale (BBS), functional ambulation category (FAC), and Modified Barthel Index (MBI). Both groups received an identical rehabilitation program for 8 weeks. Results: Significant within-group improvements were observed in both groups across all measures (p < 0.05). However, the stroke with sarcopenia group showed significantly less improvement in MMT, BBS, FAC, and MBI compared to the stroke without sarcopenia group at both 4 and 8 weeks (p < 0.05). Conclusions: These results underscore the significant impact of sarcopenia on functional recovery in stroke patients, despite both groups receiving identical rehabilitation programs. The presence of sarcopenia was a critical predictor of poorer outcomes in muscle strength, balance, ambulation, and activities of daily living. Given these findings, specific rehabilitation strategies targeting sarcopenia are needed to improve recovery in stroke patients. Future research should include larger sample sizes, longer follow-ups, and sarcopenic patient-specific rehabilitation programs. Full article
(This article belongs to the Special Issue New Advances in Acute Stroke Rehabilitation)
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12 pages, 1152 KiB  
Article
Effects of Upper Limb Control on the Less-Affected Side on Upper Limb Function, Respiration, Balance, and Activities of Daily Living in Stroke
by Ju-O Kim, Mi-Young Lee and Byoung-Hee Lee
Medicina 2024, 60(6), 937; https://doi.org/10.3390/medicina60060937 - 3 Jun 2024
Viewed by 2007
Abstract
Background and Objectives: This study aimed to investigate the effects of upper limb control exercises on upper limb function, respiration, balance, and activities of daily living in patients with stroke. Materials and Methods: The 28 patients who met the selection criteria were randomly [...] Read more.
Background and Objectives: This study aimed to investigate the effects of upper limb control exercises on upper limb function, respiration, balance, and activities of daily living in patients with stroke. Materials and Methods: The 28 patients who met the selection criteria were randomly assigned to two groups of 14 patients each. Subsequently, upper limb control exercises using real-time feedback were applied. The same interventional exercise was applied to both the less-affected and affected limbs of the study participants, who were classified into a less-affected side upper limb control group and an affected side upper limb control exercise group. Interventional exercises, 30 min each, were performed five times weekly for 4 weeks, and follow-up examinations were performed 2 weeks after the end of exercise. Electronic muscle strength measurements and an electronic goniometer were used to evaluate upper limb function. A spirometer was used to measure respiration. Balance ability was evaluated using a force plate pressure distribution measuring system with a sensor that detects the movement of the body center on the ground. Daily life movements were evaluated using the Korean version of the modified Barthel index. Results: When examining the results, the upper limb function on the paralyzed side showed an increase in the electromyographic strength of shoulder joint depression and flexion angle. Improvements were also observed in respiration (forced vital capacity [L] and forced expiratory volume in 1 s [L]), balance (95% confidence ellipse area [mm2] and center of pressure displacement [mm]), and daily life activities, all of which showed statistically significant differences in the time × group interaction effect (p < 0.05). Conclusions: Thus, it was found that the upper limb control exercise on the less-affected side had a significant effect when the exercise was performed together with treatment on the affected side in patients with stroke. It is anticipated that this study will provide basic data for evaluating both the trunk and upper limbs of the less-affected and affected sides. Full article
(This article belongs to the Special Issue New Advances in Acute Stroke Rehabilitation)
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