{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T09:06:31Z","timestamp":1784192791163,"version":"3.55.0"},"reference-count":34,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objective: This study aimed to determine whether robot-assisted therapy, low-frequency rTMS, or intensive therapist-guided upper-limb training provides additional recovery beyond self-directed training in individuals 4\u20139 months post-stroke. Design: A five-phase single-case experimental study was conducted with two baseline phases and three randomized 3-week intervention phases. Subjects\/Patients: Sixteen adults with moderate-to-severe upper-limb motor impairment in the late subacute phase after stroke (4\u20139 months post-stroke) were included. Methods: Participants completed intensive task-oriented training, low-frequency rTMS, and robot-assisted therapy in a randomized order. Primary outcomes were Fugl\u2013Meyer Assessment for the Upper Extremity (FMA-UE), active range of motion, and muscle strength. Secondary outcomes included EQ-5D and WHODAS 2.0. Results: FMA-UE motor scores improved significantly over the study period (8\u201310 points). However, comparable gains occurred during baseline phases. rTMS and intensive training produced within-phase improvements, whereas robotic therapy did not. Participants with higher initial FMA-UE scores improved, while those with severe paresis showed minimal benefit and occasional decline during rTMS. Disability and quality-of-life measures remained stable. Gains were maintained at 1-year follow-up. Conclusions: In the late subacute phase after stroke, modest upper-limb motor improvements occurred, but effects were not clearly attributable to specific interventions beyond ongoing recovery. Treatment response depended strongly on baseline motor severity, with limited benefit in severe paresis.<\/jats:p>","DOI":"10.3390\/jcm15145564","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T03:34:23Z","timestamp":1784172863000},"page":"5564","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Upper-Limb Motor Recovery in the Late Subacute Phase After Stroke: A Single-Case Experimental Study of Robot-Assisted Therapy, rTMS, and Intensive Training for Upper-Limb Rehabilitation in the First Year After Stroke Using Modern Treatment Strategies"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8887-1641","authenticated-orcid":false,"given":"Hannu","family":"Heikkil\u00e4","sequence":"first","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Kuopio University Hospital, University of Eastern Finland, FI-70210 Kuopio, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aet","family":"Ristm\u00e4gi","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Kuopio University Hospital, University of Eastern Finland, FI-70210 Kuopio, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1750-7695","authenticated-orcid":false,"given":"Olavi","family":"Airaksinen","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Kuopio University Hospital, University of Eastern Finland, FI-70210 Kuopio, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1482","DOI":"10.1161\/STROKEAHA.110.604090","article-title":"Early prediction of outcome of activities of daily living after stroke: A systematic review","volume":"42","author":"Veerbeek","year":"2011","journal-title":"Stroke"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1016\/j.apmr.2007.08.162","article-title":"Mirror therapy improves hand function in subacute stroke: A randomized controlled trial","volume":"89","author":"Yavuzer","year":"2008","journal-title":"Arch. 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