Special Issue: Breakthroughs in Stroke Rehabilitation: Bridging Engineering,Neuroscience,and Motor Control

Stroke remains one of the leading causes of death and long-term disability worldwide. Despite decades of research and substantial progress in medical management and treatment of stroke, meaningful recovery of motor function continues to be a major challenge. In light of this challenge, a major thrust of recent research is to advance mechanistic understanding of stroke recovery and to develop more clinically feasible and scalable interventions. This special issue of Restorative Neurology and Neuroscience, titled “Breakthroughs in Stroke Rehabilitation: Bridging Engineering, Neuroscience, and Motor Control,” brings together a collection of contributions that reflect the growing convergence across engineering, neuroscience, and motor control and their collective potential to transform stroke rehabilitation. We discuss these contributions under four major themes below.

Foundational Perspectives

A first theme emerging from this issue is the importance of strong theoretical foundations and methodological rigor in advancing the science of neurorehabilitation. Krishnan et al. outline ten key recommendations aimed at improving the scientific quality, experimental rigor, and reproducibility of stroke rehabilitation studies (Krishnan et al., 2025). These recommendations emphasize the need to clearly define active ingredients, incorporate mechanistic outcome measures, and adopt rigorous methodological practices. Complementing this perspective, McGuirk and Patten provide a timely and thought-provoking overview of computer vision-based motion capture technologies, highlighting both their promise and limitations while offering a pragmatic roadmap for their integration into clinical practice (McGuirk and Patten, 2026). Together, these papers establish a critical foundation for interpreting and advancing the work presented in this issue.

Neuroplasticity, Neuromodulation, and Cognition

A second theme of this special issue is facilitating neuroplasticity through neuromodulation, behavioral interventions, and cognitive integration. Madhavan reviews the role of cortical priming in facilitating neuroplasticity, synthesizing evidence across a range of approaches, including non-invasive brain stimulation, deep brain stimulation (DBS), vagus nerve stimulation (VNS), brain-computer interfaces (BCIs), movement-based priming, aerobic exercise, and sensory-based interventions (Madhavan, 2025). Extending this theme, Alhalabi et al. provide meta-analytic evidence supporting the efficacy of repetitive transcranial magnetic stimulation (rTMS) for improving upper limb motor function and independence, particularly when intervention parameters are optimized with an appropriate number of treatment sessions (15–20 sessions) during the sub-acute stage of stroke (Alhalabi et al., 2025). Mark et al. introduce an innovative neuromodulation framework centered on operant conditioning of corticomuscular coherence, proposing a biologically grounded strategy to strengthen functional connectivity between the brain and muscles (Mark et al., 2025). Finally, Delmas et al. highlight the role of cognition in functional recovery and motor rehabilitation by demonstrating that cognitive impairments after stroke are strongly associated with deficits in lower limb motor control during driving and increased crash risk (Delmas et al., 2025). Collectively, these studies reinforce the notion that motor recovery and function are driven by dynamic interactions between neural plasticity, behavior, and cognition.

Neurophysiology and Motor Control

A third theme of this special issue advances our understanding of neurophysiological mechanisms underlying post-stroke impairments and motor control. Jin et al. investigate interhemispheric interactions and demonstrate that excessive contralesional crossed facilitation may impair bimanual coordination, particularly in individuals with less severe motor deficits (Jin et al., 2025). At the spinal level, Correa et al. provide novel evidence linking homosynaptic depression of the soleus H-reflex to gait performance (i.e., gait speed), suggesting that reflex modulation may play a functional role in locomotor recovery after stroke (Correa et al., 2026). Shin et al. distinguish the effects of stroke and aging on plantarflexor strength and voluntary activation, highlighting stroke-specific deficits in neural drive (Shin et al., 2026). Complementing these findings, Ding et al. show that non-paretic hand exercise performed to task failure can acutely enhance beta-band intermuscular coherence in the paretic hand, suggesting a potential cross-limb mechanism to transiently strengthen corticospinal connectivity and improve dexterity (Ding et al., 2026). Together, these studies emphasize the importance of multilevel physiological mechanisms (i.e., from cortical to spinal) in shaping motor recovery and informing targeted interventions.

Measurement, Assessment, and Rehabilitation Technologies

The final theme of this special issue showcases advancements in measurement, assessment, and rehabilitation technologies, reflecting the increasing integration of engineering innovations into clinical research and practice. Hawe et al. demonstrate the feasibility of video-based pose estimation to capture detailed features of movement quality and compensatory strategies that are generally missed by traditional clinical assessments (Hawe et al., 2026). Foley et al. show that hip, knee, and ankle joint quasi-stiffnesses of stroke survivors can be estimated with reasonable accuracy using 2D motion capture data, supporting the potential of low-cost 2D motion capture systems for broader clinical adoption (Foley et al., 2025). Albrecht et al. critically evaluate the added value of kinematic assessments relative to standard clinical measures in predicting functional independence and show that while kinematic assessments did not outperform clinical assessments in individuals with severe hemiparesis (Albrecht et al., 2025), kinematic assessments can complement clinical measures by detecting subtle ipsilesional deficits that standardized assessments may miss. Extending assessment into real-world contexts, Ruotsalainen et al. use wearable accelerometers to characterize gait impairments in both stroke and transient ischemic attack (TIA) populations, demonstrating the sensitivity of these tools for early detection and monitoring of functional deficits after stroke or TIA (Ruotsalainen et al., 2025).

This issue also highlights the growing emphasis on accessible and user-centered rehabilitation technologies. Augenstein and Krishnan provide a comprehensive review of low-cost rehabilitation devices, emphasizing strategies to improve accessibility, scalability, and real-world implementation (Augenstein and Krishnan, 2026). Augenstein et al. further examine the biomechanical and neuromuscular effects of soft versus traditional ankle-foot orthoses (AFOs), demonstrating that soft AFOs may better preserve ankle mobility and facilitate normal ankle function during walking (Augenstein et al., 2025). Finally, Mazorow et al. explore the use of vibrotactile kinesthetic feedback for improving reach-to-grasp performance, offering important insights into both the potential benefits and limitations of sensory augmentation approaches (Mazorow et al., 2026). Together, these contributions highlight the importance of designing technologies that are not only effective but also feasible for widespread clinical and home use.

Collectively, the interdisciplinary articles in this special issue reflect a field that is increasingly advancing mechanistic understanding and aligning technological innovation with clinical feasibility and real-world relevance. These contributions move beyond traditional disciplinary boundaries and provide critical insights into the mechanisms and treatment of post-stroke impairments. As guest editors, we hope that this collection, which captures the current state-of-the-art, also catalyzes future research that ultimately improves outcomes for individuals living with stroke.