{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T17:22:49Z","timestamp":1793380969108,"version":"4.5.0"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Recovery of upper-limb motor function after stroke often requires intensive, repetitive, task-oriented rehabilitation. Multimodal sensory-feedback robot-assisted training has the potential to enhance patient engagement and sensorimotor integration, and thereby improve rehabilitation outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To investigate the clinical and neurophysiological effects of adding multimodal sensory-feedback robot-assisted training to conventional rehabilitation for post-stroke upper-limb recovery using functional near-infrared spectroscopy (fNIRS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A total of 38 stroke patients were randomly assigned to a control group (conventional rehabilitation,\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f19) or an experimental group (dose-matched conventional rehabilitation plus multimodal sensory-feedback robot-assisted training,\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f19). Upper-limb motor function was assessed before and after intervention using the Fugl-Meyer Assessment for the Upper Extremity (FMA-UE). fNIRS was used to evaluate resting-state functional connectivity (Fisher z-transformed connectivity, zFC) and task-evoked cortical activation (HbO) during shoulder, elbow, and finger flexion tasks.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      No significant between-group difference in FMA-UE was observed at baseline (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;gt;\u202f0.05). After intervention, the experimental group showed significant improvement in FMA-UE, whereas the control group showed a smaller, non-significant improvement; the magnitude of pre\u2013post change differed significantly between groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). Resting-state fNIRS showed no significant between-group differences in zFC at baseline, whereas post-intervention analyses showed enhanced fronto-motor zFC in the experimental group, including connections involving PreM&amp;amp;SMC, DLPFC, and FEF. Task-fNIRS revealed channel-specific group \u00d7 time interaction effects in HbO responses during the three motor tasks;\n                      <jats:italic>post-hoc<\/jats:italic>\n                      analyses showed significant post-intervention reductions in cortical activation at selected channels in the control group, whereas the experimental group showed a relatively preserved activation pattern.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Adding multimodal sensory-feedback robot-assisted training to dose-matched conventional rehabilitation may improve short-term post-stroke upper-limb motor recovery. fNIRS further revealed intervention-related changes in cortical activation and resting-state functional connectivity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration<\/jats:title>\n                    <jats:p>Identifier, ChiCTR2400080101.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1820579","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T04:24:27Z","timestamp":1788495867000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical efficacy and cortical network modulation of a multimodal sensory feedback upper-limb rehabilitation robot for post-stroke upper-limb recovery: a randomized controlled trial"],"prefix":"10.3389","volume":"17","author":[{"given":"Li-Hui","family":"Zhao","sequence":"first","affiliation":[{"name":"School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun-Peng","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine","place":["Shanghai, China"]},{"name":"Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia-Jia","family":"Wu","sequence":"additional","affiliation":[{"name":"Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education","place":["Shanghai, China"]},{"name":"Department of Rehabilitation Medicine,Yueyang Hospital of Integrated Traditional Chinese Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Zhoupu Hospital","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhan-Yue","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Zhoupu Hospital","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xu-Yun","family":"Hua","sequence":"additional","affiliation":[{"name":"Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education","place":["Shanghai, China"]},{"name":"Department of Traumatology and Orthopedics, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xia","family":"Bi","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Zhoupu Hospital","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian-Guang","family":"Xu","sequence":"additional","affiliation":[{"name":"School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine","place":["Shanghai, China"]},{"name":"Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education","place":["Shanghai, China"]},{"name":"Department of Rehabilitation Medicine,Yueyang Hospital of Integrated Traditional Chinese Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,4]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1016\/S1474-4422(21)00252-0","article-title":"Global, regional, and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the global burden of disease study 2019","volume":"20","year":"2021","journal-title":"Lancet Neurol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1186\/s12984-024-01372-3","article-title":"Effect of task-oriented training assisted by force feedback hand rehabilitation robot on finger grasping function in stroke patients with hemiplegia: a randomised controlled trial","volume":"21","author":"Li","year":"2024","journal-title":"J Neuroeng Rehabil"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"684019","DOI":"10.3389\/fnbot.2021.684019","article-title":"Robot-assisted therapy and constraint-induced movement therapy for motor recovery in stroke: results from a randomized clinical trial","volume":"15","author":"Terranova","year":"2021","journal-title":"Front Neurorobot"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1186\/s12984-020-0646-1","article-title":"Effects of robot therapy on upper body kinematics and arm function in persons post stroke: a pilot randomized controlled trial","volume":"17","author":"Carpinella","year":"2020","journal-title":"J Neuroeng Rehabil"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"2182","DOI":"10.1161\/STROKEAHA.121.037260","article-title":"Robot-assisted training as self-training for upper-limb hemiplegia in chronic stroke: a randomized controlled trial","volume":"53","author":"Takebayashi","year":"2022","journal-title":"Stroke"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2022\/9933018","article-title":"Gait recognition for lower limb exoskeletons based on interactive information fusion","volume":"2022","author":"Chen","year":"2022","journal-title":"Appl Bionics Biomech"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"3255","DOI":"10.1111\/jan.14800","article-title":"Virtual reality for limb motor function, balance, gait, cognition and daily function of stroke patients: a systematic review and meta-analysis","volume":"77","author":"Zhang","year":"2021","journal-title":"J Adv Nurs"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"646698","DOI":"10.3389\/fnins.2021.646698","article-title":"Multisensory integration in stroke patients: a theoretical approach to reinterpret upper-limb proprioceptive deficits and visual compensation","volume":"15","author":"Bernard-Espina","year":"2021","journal-title":"Front Neurosci"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"CD008349","DOI":"10.1002\/14651858.CD008349.pub5","article-title":"Virtual reality for stroke rehabilitation","volume":"6","author":"Laver","year":"2025","journal-title":"Cochrane Database Syst Rev"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1038\/s41586-021-04129-3","article-title":"Contextual inference underlies the learning of sensorimotor repertoires","volume":"600","author":"Heald","year":"2021","journal-title":"Nature"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1506889","DOI":"10.3389\/fneur.2025.1506889","article-title":"Tailoring robot-assisted arm training to individuals with stroke: bridging neuroscience principles and clinical practice","volume":"16","author":"Morone","year":"2025","journal-title":"Front Neurol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"21","DOI":"10.3758\/s13423-012-0333-8","article-title":"Augmented visual, auditory, haptic, and multimodal feedback in motor learning: a review","volume":"20","author":"Sigrist","year":"2013","journal-title":"Psychon Bull Rev"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"9226028251358162","DOI":"10.1177\/09226028251358162","article-title":"Harnessing neuroplasticity: the role of priming in enhancing post stroke motor function","volume":"1","author":"Madhavan","year":"2025","journal-title":"Restor Neurol Neurosci"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1168773","DOI":"10.3389\/fnins.2023.1168773","article-title":"The analysis of brain functional connectivity of post-stroke cognitive impairment patients: an fNIRS study","volume":"17","author":"Zou","year":"2023","journal-title":"Front Neurosci"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"023515","DOI":"10.1117\/1.NPh.10.2.023515","article-title":"Using preregistration as a tool for transparent fNIRS study design","volume":"10","author":"Schroeder","year":"2023","journal-title":"Neurophotonics"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1016\/j.jht.2025.04.004","article-title":"Fugl-Meyer assessment for upper extremity in stroke: a pyschometric systematic review","volume":"39","author":"de Blas-Zamorano","year":"2025","journal-title":"J Hand Ther"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"031414","DOI":"10.1117\/1.NPh.3.3.031414","article-title":"Review of functional near-infrared spectroscopy in neurorehabilitation","volume":"3","author":"Mihara","year":"2016","journal-title":"Neurophotonics"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"e00804","DOI":"10.1016\/j.neurot.2025.e00804","article-title":"Lifespan dynamics of STN-based functional connectivity and network properties: implications for motor dysfunction and circuit-based neuromodulation","volume":"18","author":"Li","year":"2025","journal-title":"Neurotherapeutics"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"505","DOI":"10.3389\/fnhum.2018.00505","article-title":"Current status and issues regarding pre-processing of fNIRS neuroimaging data: an investigation of diverse signal filtering methods within a general linear model framework","volume":"12","author":"Pinti","year":"2019","journal-title":"Front Hum Neurosci"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1095","DOI":"10.2147\/JPR.S492361","article-title":"Cortical activation and functional connectivity response to different interactive modes of virtual reality (VR)-induced analgesia: a prospective functional near-infrared spectroscopy (fNIRS) study","volume":"18","author":"Deng","year":"2025","journal-title":"J Pain Res"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"3293","DOI":"10.1523\/JNEUROSCI.4399-14.2015","article-title":"Granger causality analysis in neuroscience and neuroimaging","volume":"35","author":"Seth","year":"2015","journal-title":"J Neurosci"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1532783","DOI":"10.3389\/fnhum.2025.1532783","article-title":"Decoding the brain-machine interaction for upper limb assistive technologies: advances and challenges","volume":"19","author":"Ghosh","year":"2025","journal-title":"Front Hum Neurosci"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1042254","DOI":"10.3389\/fneur.2023.1042254","article-title":"Upper limb intelligent feedback robot training significantly activates the cerebral cortex and promotes the functional connectivity of the cerebral cortex in patients with stroke: a functional near-infrared spectroscopy study","volume":"14","author":"Li","year":"2023","journal-title":"Front Neurol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1561","DOI":"10.1111\/cns.14118","article-title":"Screening diagnosis of executive dysfunction after ischemic stroke and the effects of transcranial magnetic stimulation: a prospective functional near-infrared spectroscopy study","volume":"29","author":"Liu","year":"2023","journal-title":"CNS Neurosci Ther"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"D280","DOI":"10.1364\/ao.48.00d280","article-title":"HomER: a review of time-series analysis methods for near-infrared spectroscopy of the brain","volume":"48","author":"Huppert","year":"2009","journal-title":"Appl Opt"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"428","DOI":"10.1016\/j.neuroimage.2008.08.036","article-title":"NIRS-SPM: statistical parametric mapping for near-infrared spectroscopy","volume":"44","author":"Ye","year":"2009","journal-title":"NeuroImage"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"e45662","DOI":"10.1097\/MD.0000000000045662","article-title":"Effects of different rehabilitation therapies on upper extremity motor function and activities of daily living in hemiplegic patients with stroke: a network meta-analysis","volume":"104","author":"Xu","year":"2025","journal-title":"Medicine (Baltimore)"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1060734","DOI":"10.3389\/fnagi.2022.1060734","article-title":"fNIRS-based brain functional response to robot-assisted training for upper-limb in stroke patients with hemiplegia","volume":"14","author":"Huo","year":"2022","journal-title":"Front Aging Neurosci"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"1599","DOI":"10.1177\/02692155211017360","article-title":"Dual-task walking and automaticity after stroke: insights from a secondary analysis and imaging sub-study of a randomised controlled trial","volume":"35","author":"Collett","year":"2021","journal-title":"Clin Rehabil"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"39704","DOI":"10.1038\/s41598-025-23267-6","article-title":"Unveiling the upper-limb functional recovery mechanisms in stroke patients using brain-machine interfaces: a near-infrared functional imaging-based study","volume":"15","author":"Zhang","year":"2025","journal-title":"Sci Rep"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"103772","DOI":"10.1016\/j.nicl.2025.103772","article-title":"Short-term BCI intervention enhances functional brain connectivity associated with motor performance in chronic stroke","volume":"46","author":"Grigoryan","year":"2025","journal-title":"Neuroimage Clin"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"1256","DOI":"10.1007\/s00415-023-12060-y","article-title":"Immersive virtual reality-based rehabilitation for subacute stroke: a randomized controlled trial","volume":"271","author":"Huang","year":"2024","journal-title":"J Neurol"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1820579\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T04:24:28Z","timestamp":1788495868000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1820579\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,4]]},"references-count":32,"alternative-id":["10.3389\/fneur.2026.1820579"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2026.1820579","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,4]]},"article-number":"1820579"}}