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Although many rehabilitative and restorative interventions have shown promising benefits, trial outcomes remain inconsistent. A major limitation is the misalignment between intervention mechanisms and outcome measures, along with an underuse of minimal clinically important difference thresholds that define meaningful changes. This opinion focuses on motor recovery trials after ischemic stroke and highlights how inappropriate reliance on global disability scales, short-term endpoints, or mismatched impairment and activity measures can obscure true therapeutic effects. 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