Stroke Rehabilitation

A Southwest Medical University collaboration reported a meta-analysis of 16 randomized BCI stroke rehabilitation trials involving 1,761 patients. Versus conventional rehabilitation, FMA-UE had an SMD of 0.49 (95% CI 0.26–0.73) and ARAT 0.53 (0.14–0.91). Outcomes pooled subsets of trials. No significant difference was detected between 10–15 and 20–30 sessions; more sessions were not established as better. Fourteen trials had high risk of bias for participant and personnel blinding, and most had fewer than 30 participants per group.

Published in Neural Regeneration Research on August 18, 2026, the study conducted a bibliometric analysis of 3173 articles from the Web of Science Core Collection on post-stroke limb motor dysfunction and functional recovery from 2016 to 2025, by authors from Beijing Rehabilitation Hospital, Capital Medical University. The field is in a period of rapid expansion, with technology-assisted rehabilitation as the dominant trend and robot-assisted training and virtual reality as the two major technological keywords. Burst literature analysis revealed three hotspot phases, with the recent phase (2020 to present) covering neuromodulation (brain-computer interface and non-invasive brain stimulation), global disease burden and public health policy. Highly cited studies focus on comparative efficacy, robot-assisted training, brain-computer interfaces, vagus nerve stimulation and prediction of rehabilitation outcomes.

A new clinical trial at Brazil's Santos Dumont Institute will test whether brain-computer interface (BCI)-guided functional electrical stimulation (FES) can improve muscle activation and gait in people with spinal cord injury. The institute is a well-known Brazilian center for neurorehabilitation research. Registered on ClinicalTrials.gov as NCT07768930 and first posted on August 17, 2026, the study is active but not yet recruiting. The intervention involves ankle dorsiflexion rehabilitation: patients wear an EEG cap, the system detects motor-imagery-related brain signals in real time, and when an intention is detected, it triggers FES to stimulate the tibialis anterior muscle to assist ankle dorsiflexion. Primary outcomes are improvements in muscle activation patterns and gait kinematics. The trial is at an early stage, with enrollment details not yet disclosed.

Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, in Wuhan, central China, is sponsoring a multicenter cohort study that aims to enroll 1,000 stroke patients. The treatment arm receives closed-loop rehabilitation combining a brain-computer interface with functional electrical stimulation, and the control arm receives conventional training; the primary endpoint is change in upper- and lower-limb FMA scores two weeks after enrollment. Registered with the Chinese Clinical Trial Registry as ChiCTR2600130037 on August 13, 2026, the study plans first enrollment on September 1, 2026 and has not yet begun recruiting. It will include patients aged 18 to 80 with ischemic or hemorrhagic stroke confirmed by MRI or CT, motor impairment of one upper and/or lower limb, and an NIHSS motor score of 1 for the affected limb. The registry lists it as an observational cohort study, phase 4, self-funded.

A study of 60 patients with subacute stroke hemiplegia found that adding motor imagery brain-computer interface training to conventional rehabilitation significantly improved upper limb motor function, simplified upper limb function scores, and daily living abilities. The experimental group of 30 received 3 weeks of additional BCI training, 5 days per week, while the control group received only conventional rehabilitation. The experimental group showed greater improvements in Fugl-Meyer upper limb scores, simplified upper limb function scores, and Barthel Index, with statistically significant differences.

A team at Tianyou Hospital, Wuhan University of Science and Technology conducted a systematic review and meta-analysis of motor imagery-based BCI training for upper limb dysfunction in people with post-stroke hemiplegia. The review included 27 studies; 24 studies involving 846 participants contributed to the meta-analyses. Compared with the respective study controls, training produced statistically significant improvements on upper limb motor assessments reflecting isolated movement and fine motor control. Effects on complex functional activities, activities of daily living and spasticity were not statistically significant. Because control conditions varied and included sham interventions, the evidence does not establish superiority over standardised traditional rehabilitation.

The trial compares motor imagery BCI plus standard rehabilitation against standard rehabilitation alone in stroke patients with hemiplegia, tracking limb motor function and daily living ability. It planned to enroll 60 participants, 30 per arm, with the first participant enrolled on August 10, 2022; the registry now lists the study as completed. Beyond motor scales, the primary outcomes include functional connectivity and a lateralization index measured with fNIRS, probing brain-network changes rather than behavior scores alone.

A newly registered trial tests a brain-computer interface in post-stroke rehabilitation across 4 parallel arms: full cross-domain (emotion-cognition-motor) adaptive training, integrated cognitive and motor task training, single-dimension motor training, and conventional rehabilitation. Each arm plans 22 participants, 88 in total. It enrolls patients aged 30 to 80 with a first cerebral infarction or hemorrhage 3 months to 1 year earlier, unilateral hemiplegia, and upper-limb Brunnstrom stage II to IV. The primary outcome is a motor function score; secondary outcomes include EEG motor imagery event-related synchronization/desynchronization, prefrontal theta/alpha power ratio, and EEG-fNIRS coupling.

The Chinese Clinical Trial Registry (ChiCTR) has logged a study of how brain-computer interface training built on a motor imagery paradigm affects lower-limb motor function in stroke patients. Registered on May 28, 2026 as ChiCTR2600125562, the trial is recruiting; design, sample size and sponsor are absent from the record carried by the WHO International Clinical Trials Registry Platform (ICTRP) and must be read from the original ChiCTR entry.

The randomized controlled trial plans to enroll 60 patients with lower limb motor impairment after stroke, with the intervention group receiving BCI-assisted exoskeleton rehabilitation training and the control group conventional walking training. Primary outcomes include lower limb surface electromyography, lower limb motor function, the Modified Barthel Index, a balance scale and functional ambulation, testing whether a BCI-driven exoskeleton adds functional benefit over conventional gait training. Punan Hospital, Pudong New Area, Shanghai is the sponsor, with first enrolment set for May 30, 2026. The trial is registered with the Chinese Clinical Trial Registry (ChiCTR) under number ChiCTR2600125531, with a registration date of May 28, 2026, and recruitment has not yet started.

The randomized controlled trial plans to enroll 58 patients with upper limb motor dysfunction after stroke. The test group will receive feedback-based rehabilitation training through brain-computer interface interaction, while the control group will undergo traditional upper limb circular motion training. The primary outcome is the Fugl-Meyer Motor Assessment-Upper Extremity (FMA-UE), with secondary outcomes covering motor function, daily living activities, quality of life and neurophysiological measures including EEG, transcranial magnetic stimulation and fNIRS. The trial was prospectively registered, with first enrolment set for June 1, 2026, and recruitment has not yet started.

The multicenter randomized controlled trial pits closed-loop BCI ankle training against conventional active and passive ankle training in subacute stroke patients who are 4 to 12 weeks past onset and have less than 10 degrees of active ankle dorsiflexion. Primary endpoints are active ankle dorsiflexion range of motion and Manual Muscle Testing of the ankle; secondary endpoints include Functional Ambulation Classification, the Berg Balance Scale and the Fugl-Meyer Motor Assessment of the Lower Limb. The trial plans to enroll 120 patients, 60 per arm, with first enrolment set for May 31, 2026.

Can a non-invasive brain-computer interface read motor intention and, combined with spinal cord stimulation and exoskeleton training, improve function after spinal cord injury? Xuanwu Hospital, Capital Medical University has registered a single-arm exploratory trial that plans to enroll 10 patients aged 18 to 65 with spinal cord injury. The intervention combines all three into one rehabilitation regimen. The primary outcome is the overall clinical efficacy rate 6 months after surgery; secondary outcomes include improvement in the Visual Analogue Scale for pain and the incidence of adverse events related to the trial devices.

The multicenter randomized controlled trial plans to enroll 222 patients who are 1 to 3 months past their first stroke and have motor impairment in the affected lower limb. The experimental group will receive 4 weeks of motor imagery-based BCI-driven active and passive lower limb training, while the control group gets 4 weeks of conventional training. The primary outcome is the Fugl-Meyer Assessment Lower Extremity Section, with balance, daily living ability and walking classification as secondary outcomes. First enrolment is set for May 31, 2026.

The trial tests whether a steady-state visual evoked potential (SSVEP) brain-computer interface can drive functional electrical stimulation of swallowing muscles more effectively than conventional neuromuscular electrical stimulation. It plans to enroll 90 patients, 45 per arm, all within 6 months of a first ischemic or hemorrhagic stroke and aged 18 to 80. The primary outcome is the Standard Swallowing Assessment, with secondary measures including the Functional Oral Intake Scale and the Penetration-Aspiration Scale. First enrollment is listed for June 1, 2026.

A trial combining tactile-feedback brain-computer interface training with motor imagery for upper-limb rehabilitation after stroke is recruiting in China. Registered with the Chinese Clinical Trial Registry as ChiCTR2600124911 on May 19, 2026 and carried by the WHO International Clinical Trials Registry Platform, the trial record is available through the WHO International Clinical Trials Registry Platform.

The trial split 54 stroke patients with hand impairment into three groups using kinesthetic, hybrid and visuomotor imagery to drive BCI training, with upper-limb Fugl-Meyer score as the primary endpoint. The registration record does not yet report which imagery mode worked best.

Shandong Provincial Hospital in eastern China has registered a pilot trial that will test whether patients with acute ischemic stroke can begin brain-signal-driven arm training within days of onset. The planned 60 participants will practice upper-limb movements with a scalp EEG brain-computer interface that reads their intention to move and gives training feedback, compared against a sham-training group. Both groups will train for 10 days on top of standard early rehabilitation, twice a day for about 30 minutes per session. The primary outcome is the change in upper-limb motor function score 30 days after randomization. The trial is not yet recruiting and is expected to start in October 2026.

Guangdong Provincial Hospital of Traditional Chinese Medicine has registered a parallel-design interventional trial, ChiCTR2600124411, that plans to enroll 81 patients with unilateral upper-limb impairment after stroke in three groups of 27. Two groups receive intermittent theta-burst stimulation (iTBS) over the dorsolateral prefrontal cortex or the primary motor cortex, and one receives sham stimulation; all three undergo motor imagery BCI training. Primary outcomes are BCI decoding accuracy, the Fugl-Meyer Assessment and brain network topology. The trial was registered on May 12, 2026 and is not yet recruiting.

A trial at Xuzhou Rehabilitation Hospital Affiliated to Xuzhou Medical University paired a motor imagery brain-computer interface with modified constraint-induced movement therapy to restore upper-limb function after stroke. The hospital is a rehabilitation specialty facility affiliated with Xuzhou Medical University, and the combined approach is meant to test whether a BCI adds benefit on top of established rehabilitation training. It planned 40 participants, 20 in the combined group and 20 in the control group, with the first patient enrolled on December 24, 2025; the registry now lists the study as completed. The primary endpoint is the Fugl-Meyer Assessment for Upper Extremity, with the Wolf Motor Function Test and modified Barthel Index as secondary measures. Funding comes from the New Round of Xuzhou "Pengcheng Talent Program" — High-level Healthcare Talent Recruitment and Development Project, project number 2025TD14. No results are posted, so whether the combined approach beats constraint therapy alone remains unknown.

The Chinese Clinical Trial Registry (ChiCTR) has logged a study of the safety and efficacy of early brain-computer interface training given after reperfusion therapy in patients with acute ischemic stroke, an attempt to pin down when in the recovery window such training should start. Registered on April 27, 2026 as ChiCTR2600123548, the trial has not begun recruiting, and design, sample size and sponsor are absent from the record carried by the WHO International Clinical Trials Registry Platform (ICTRP) and must be read from the original registration.

A trial registered with the Chinese Clinical Trial Registry combines low-frequency rTMS with motor imagery brain-computer interface therapy, using conventional physical rehabilitation as the control, with the Fugl-Meyer upper extremity scale as the primary endpoint. The study has three parts: Part I compares BCI therapy with conventional rehabilitation, while Part III compares three rTMS protocols. It plans to enroll 213 participants, with first enrolment set for May 1, 2026; recruitment has not yet begun.

The trial combines a brain-computer interface with robotic mirror therapy into a single intervention, while the control arm receives conventional comprehensive rehabilitation only. It enrolls patients aged 30 to 80 with unilateral upper-limb motor impairment 1 to 6 months after ischemic or hemorrhagic stroke, whose lesions are confined to the basal ganglia. The primary endpoint is the Fugl-Meyer Assessment of the Upper Extremity, with EEG, functional MRI and the Modified Ashworth Scale among secondary measures. The planned enrollment is 40 patients, with first enrollment set for May 1, 2026.

A trial of a dual-task brain-computer interface (BCI) combining motor-intention detection with virtual reality training is recruiting patients to measure how it affects shoulder function after rotator cuff repair surgery, following its registration with the Chinese Clinical Trial Registry (ChiCTR) on April 20, 2026. The record has been reposted by the WHO International Clinical Trials Registry Platform (ICTRP).

A brain-computer interface (BCI) trial for upper-limb motor rehabilitation after hemorrhagic stroke was registered with the Chinese Clinical Trial Registry under the number ChiCTR2600122859 on April 20, 2026, and has not yet begun recruiting. The study combines electroencephalography (EEG) with functional near-infrared spectroscopy (fNIRS). The registration record does not disclose the study design, sample size or sponsor.

A randomized controlled trial of motor-imagery brain-computer interface (BCI) training for swallowing difficulty after stroke was registered with the Chinese Clinical Trial Registry (ChiCTR) on April 9, 2026, under the number ChiCTR2600122162. It will test whether the training improves swallowing function in stroke patients, and has not yet begun recruiting.

A randomized controlled trial in 120 patients with post-stroke hemiplegia found that pairing brain-computer interface (BCI) rehabilitation training with a gait robot accelerated lower-limb recovery and improved muscle activation patterns more than either intervention on its own. After eight weeks, BCI training, gait-robot training and the combination all improved lower-limb motor function, muscle activity and gait compared with routine training, but the combined group showed the largest increases in integrated electromyography of the tibialis anterior and gastrocnemius, along with a greater gain in step frequency and a greater reduction in step width.

A new entry in the Chinese Clinical Trial Registry covers a study using brain-computer interface technology for functional recovery after stroke. The record, ChiCTR2600120924, was posted on March 23, 2026, and lists its status as not yet recruiting. The registry listing carries only bibliographic details, so the trial design, sample size and sponsor remain undisclosed.