Efficacy of digital health technologies as adjunctive functional training in occupational therapy for stroke rehabilitation: a meta-analysis

 NO efficacy percentages, so completely failed at your research!

Efficacy of digital health technologies as adjunctive functional training in occupational therapy for stroke rehabilitation: a meta-analysis

Review Article Published:14 March 2026Volume 47344 2026Cite this article Save articleNeurological SciencesAims and scopeSubmit manuscript

• Yangzi Zhang, 
• Chenshu Ge, 
• Congwei Li & 
• Fang Liu 

• 11 Accesses

• Explore all metrics 

Abstract

Background

Post-stroke rehabilitation is essential for achieving functional recovery. Using digital health technologies as adjunctive functional training within occupational therapy offers a promising approach to improve training outcomes. However, a comprehensive and updated synthesis of the efficacy of this adjunctive approach is needed.

Methods

Utilizing a systematic search strategy, we identified pertinent randomized controlled trials (RCTs) from eight databases. The emphasis was placed on stroke rehabilitation studies that incorporated both digital health technologies and occupational therapy (search date: May 27, 2025). The primary outcomes assessed included upper limb motor function and activities of daily living, while secondary outcomes encompassed hand function, balance, and cognitive function. Data were synthesized using Stata 18.0, accompanied by subgroup analyses to investigate heterogeneity.

Results

This meta-analysis included 822 stroke survivors from 18 studies. The mean difference (MD) and its 95% confidence interval (CI) were used to assess the between-group comparison at post-intervention. The results showed that adjunctive DHT intervention led to significant improvements compared to controls in upper limb motor function (MD: 6.46; 95%CI [5.29, 7.63]; P < 0.001) and activities of daily living (MD: 9.52; 95%CI [5.63, 13.41]; P < 0.001). Additionally, benefits were noted in hand function and cognitive performance. However, no statistically significant difference was found between the groups for balance function.

Conclusion

Current evidence indicates that digital health technologies, when used as an adjunctive functional training tool alongside occupational therapy, enhance upper limb motor function(NOT GOOD ENOUGH! You incompetently don't know that survivors want 100% recovery? Or you do know and are OK with failure of your survivor requirements! Take your pick: FAILURE OR INCOMPETENCE! No other options exist!)  and activities of daily living for stroke survivors.Additionally, benefits have been noted in hand function and cognitive performance. However, the impact of these technologies on balance function remains inconclusive.

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Bridging the Gap in Stroke Rehabilitation: Rising Craft’s XR Approach

 But where is the proof this is better than action observation or mirror therapy? Ask your competent? doctor that question. Your doctor has over a decade to know that answer. In my opinion, not knowing is pure incompetence!

• action observation (127 posts to May 2011)

• mirror therapy (119 posts to October 2012)

 The latest here:

Bridging the Gap in Stroke Rehabilitation: Rising Craft’s XR Approach

Rising Craft (official site) is a company that aims to improve rehabilitation by using the brain’s visual cortex to improve stroke patients’ quality of life.

In Korea (and probably in many other countries), strokes have become the #1 cause of disabilities, according to Rising Craft, with 72% of patients having after-effects, including hemiplegia, a well-known consequence of strokes. It’s fair to say that many of us know someone who has been affected by a stroke.

Millions of people worldwide have experienced such an unfortunate event, and in (south) Korea alone, there are more than 630,000 patients who need Billions of dollars of annual medical expenses.

Unfortunately, rehabilitation is a very long process as the brain needs to be re-wired, and such long-term rehabilitation would be too expensive to provide in a medical facility. As such, patients are typically sent home as soon as possible. As you can imagine, the recovery can be less than optimum.

And that’s exactly why Rising Craft came up with TiU medi, a digital rehabilitation solution that can be used “from the hospital to the home.” It works by having software and equipment for clinical environments to be used in the first days/weeks when it’s most crucial. There’s also an “at home” device/app combo that patients can use by themselves or with the help of a family member or an at-home care professional.

Either way, the data is safely recorded, giving medical staff and experts a chance to keep track of the recovery journey without requiring patients to visit a medical facility, thus keeping costs low. So, how does it work?

As mentioned at the beginning, it’s about using the visual cortex to stimulate the brain into a path of recovery. In essence, it is akin to “simulating” the effect of having an arm or a leg moving (from the brain’s point of view), even though the affected limb doesn’t move (yet).

This simulation (or emulation) works by using XR technologies (augmented reality or extended reality) to have the brain visualize certain movements. In turn, this affects the brain’s plasticity and helps overall recovery. For example, some visual effects are based on the recognized mirror therapy that can significantly improve medical outcomes.

The great thing with virtual training is that it is possible to control the progression grade and offers great potential to gauge the current recovery point of a patient objectively.

Another advantage of XR training is that it can target specific activities or needs, such as rehabilitation training, occupational training, cognitive training, or mind care (dementia-related illnesses).

To fulfil its goal of maximizing the number of patients it can help, it is a product that is designed to be highly cost-efficient, according to Rising Craft. At the same time, it requires much less space to install and operate than existing alternatives, further decreasing indirect costs. The company estimates that this system costs 19-44% less to operate.

From a business standpoint, there’s a two-pronged approach with a B2B and a B2C model. The B2B aspect involves selling professional-grade hardware, support, and maintenance. On the other hand, the consumer product can be rented out, but there’s a monthly subscription fee of about $68.

Since it’s a global medical product, TiU medi needs to gain some government approvals and certifications, and Korea will obviously become the core market in the short term. However, the product is scheduled to enter (U.S.) FDA pre-approval in 2024, with an overseas (outside of Korea) clinical trial set for 2025 if everything goes well. Rising Craft is going to CES 2024 to meet with potential global partners.

If you search for “stroke patients XR VR technologies”, there is a good amount of research that validates this approach, so Rising Craft is on the right track, and it might come down to how fast the company can get to market and whether its implementation will surpass its competitors.

The more researchers and companies innovate on this front. The sooner patients will benefit, so we hope to hear of great medical outcome data from patients in the near future.

 

Digital rehab proves promising for stroke recovery

Sounds good but this still cherry picks higher functioning patients. 

Digital rehab proves promising for stroke recovery

Sydney’s Prince of Wales Hospital has begun trialling touchscreen rehabilitation devices to deliver therapeutic games for patients with acquired brain injuries like strokes.

The solution, dubbed EDNA, was developed by researchers at RMIT University and the Australian Catholic University to improve early access to rehabilitation following a stroke and ongoing at-home care.

EDNA was initially designed for use with tabletop-sized touchscreen device, coupled with graspable tools of different shapes for therapeutic games that promote brain plasticity to help patients regain motor, cognitive and functional ability.

Game data is then collected in the cloud, meaning patients can use the device when they return home and therapists can remotely monitor their recovery.

“EDNA is the first upper-limb brain injury rehabilitation system to integrate clinic and home therapy to monitor recovery, so there’s great potential to transform the industry and improve outcomes for patients,” said RMIT’s lead researcher, associate professor Jonathan Duckworth.

“We designed EDNA so that patients could be doing therapy without it feeling like therapy.”

Prince of Wales is one of the hospitals currently engaged in a trial of smaller tablet devices to make EDNA more accessible by removing the need for a desk-sized touchscreen.

Occupational therapist at the Prince of Wales, Karin Vogel, said the digital platform is quite different from traditional therapy.

“I feel it’s making a great difference to patients’ upper limb or arm recovery, especially intensifying the level of practice targeting the wrists, the fingers,” Vogel said.

“For me it’s been a great benefit. The fact that I can monitor patients’ performance and engagement with the technology online, it means I can service a greater amount of patients living at home in the community while I’m sitting at the office.

“I can see how often they’ve done it, how long they’ve done it, how long they’ve done it for, what elements they’ve used and if I need I can give them a ring and ask them to change things or I can change the prescription on the web as well.”

A randomised clinical trial showed stroke patients who incorporated EDNA into their treatment programs experienced an improvement two to three times greater than those who received only conventional therapy.

Duckworth said that while the results can't yet be used to predict longer-term recovery, the findings are promising and show the potential value of including EDNA as part of a therapy practices.

Dr Jeff Rogers, neuropsychologist and principle investigator of the project, said that the end goal of the research was for patients to be able to do the things that are important for them as independently as possible.

“In Australia about 50,000 people a year suffer stroke and about two-thirds to three-quarters of those people are left with significant movement difficulties and cognitive impairment - the overwhelming majority.

“What that means is stroke is a leading cause of disability here in Australia as well as worldwide.”