{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T12:58:56Z","timestamp":1770814736034,"version":"3.50.1"},"reference-count":69,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T00:00:00Z","timestamp":1768435200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Although several meta-analyses have evaluated the effects of motor imagery (MI) on upper-limb recovery using the Fugl-Meyer Assessment for the Upper Extremity (FM-UE), evidence based on more specific (Action Research Arm Test, ARAT) and functional (Barthel Index, BI) outcomes remains scarce. This study examined the effect of MI combined with conventional rehabilitation therapy (CRT), which translates into meaningful improvements in upper-limb performance and functional independence after stroke, accounting for methodological quality and publication bias. Materials and Methods: A systematic review and meta-analysis were carried out in accordance with PRISMA recommendations, with prior registration in PROSPERO (CRD420251120044). Comprehensive searches were conducted across six electronic databases up to July 2025. The methodological rigor of the included studies was evaluated using the PEDro scale, and risk of bias was appraised with the Cochrane RoB 2 instrument. Random-effects models estimated pooled effect sizes (ESs) for the ARAT and BI, alongside analyses of heterogeneity, publication bias, and moderators. Results: Eleven RCTs (n = 425) were included. A small pooled improvement in ARAT was observed (ES = 0.25; 95% CI: 0.13\u20130.37; p &lt; 0.001); however, this effect was rendered non-significant after correction for publication bias (ES = 0.08; 95% CI: \u22120.14\u20130.31). No significant differences were found for the BI (ES = 0.41; 95% CI: \u22120.35\u20131.18; p = 0.268), with substantial heterogeneity (I2 = 96.6%). The mean PEDro score was 6.6, indicating moderate methodological quality. Conclusions: MI combined with CRT yields small and inconsistent effects on upper-limb recovery and no improvement in functional independence. Current evidence does not support its routine use in stroke rehabilitation. Well-designed, adequately powered randomized controlled trials employing standardized MI protocols are required to determine its true clinical relevance.<\/jats:p>","DOI":"10.3390\/medicina62010174","type":"journal-article","created":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T16:21:13Z","timestamp":1768494073000},"page":"174","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Stroke Neurorehabilitation and the Role of Motor Imagery Training: Do ARAT and Barthel Index Improvements Support Its Clinical Use? A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8349-0441","authenticated-orcid":false,"given":"Luis","family":"Polo-Ferrero","sequence":"first","affiliation":[{"name":"Department of Nursing and Physiotherapy, Universidad de Salamanca, 37007 Salamanca, Spain"},{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de Salamanca (IBSAL), 37007 Salamanca, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4335-5086","authenticated-orcid":false,"given":"Javier","family":"Torres-Alonso","sequence":"additional","affiliation":[{"name":"Department of Nursing and Physiotherapy, Universidad de Salamanca, 37007 Salamanca, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4791-6513","authenticated-orcid":false,"given":"Juan Luis","family":"S\u00e1nchez-Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de Salamanca (IBSAL), 37007 Salamanca, Spain"},{"name":"Department of Medicine, Universidad de Salamanca, 37007 Salamanca, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6467-5036","authenticated-orcid":false,"given":"Sara","family":"Hern\u00e1ndez-Rubia","sequence":"additional","affiliation":[{"name":"Department of Nursing and Physiotherapy, Universidad de Salamanca, 37007 Salamanca, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda","family":"Agudo Juan","sequence":"additional","affiliation":[{"name":"Department of Psychobiology, Pontifical University of Salamanca, 37002 Salamanca, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9606-3791","authenticated-orcid":false,"given":"Rub\u00e9n","family":"P\u00e9rez-Elvira","sequence":"additional","affiliation":[{"name":"Department of Psychobiology, Pontifical University of Salamanca, 37002 Salamanca, Spain"},{"name":"Laboratory of Neuripsychophysiology, NEPSA Rehabilitaci\u00f3n Neurol\u00f3gica, 37003 Salamanca, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5966-8556","authenticated-orcid":false,"given":"Javier","family":"Oltra-Cucarella","sequence":"additional","affiliation":[{"name":"Department of Health Psychology, Universidad Miguel Hern\u00e1ndez de Elche, Avda. de la Universidad s\/n, 03202 Elche, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,15]]},"reference":[{"key":"ref_1","unstructured":"GBD 2021 Diseases and Injuries Collaborators (2024). Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries. Lancet, 403, 2133\u20132161."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Shen, S., Chu, T., Wang, J., Zhao, H., Tang, J., Xu, L., Ni, W., Tan, L., and Chen, Y. (2025). Progress in the application of motor imagery therapy in upper limb motor function rehabilitation of stroke patients with hemiplegia. Front. Neurol., 16.","DOI":"10.3389\/fneur.2025.1454499"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2251","DOI":"10.1113\/JP283703","article-title":"Use of a physiological profile to document upper limb motor impairment in ageing and in neurological conditions","volume":"601","author":"Ingram","year":"2023","journal-title":"J. Physiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1177\/1941874414561023","article-title":"Emerging treatments for motor rehabilitation after stroke","volume":"5","author":"Claflin","year":"2015","journal-title":"Neurohospitalist"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1186\/s12984-019-0570-4","article-title":"Bimanual coordination deficits in hands following stroke and their relationship with motor and functional performance","volume":"16","author":"Lai","year":"2019","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1435","DOI":"10.1080\/09638288.2016.1200676","article-title":"Long-term impact of stroke on patients\u2019 health-related quality of life","volume":"39","author":"Theuns","year":"2017","journal-title":"Disabil. Rehabil."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Santisteban, L., T\u00e9r\u00e9metz, M., Bleton, J.P., Baron, J.C., Maier, M.A., and Lindberg, P.G. (2016). Upper limb outcome measures used in stroke rehabilitation studies: A systematic literature review. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0154792"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"de Blas-Zamorano, P., Montagut-Mart\u00ednez, P., P\u00e9rez-Cruzado, D., and Merchan-Baeza, J.A. (2025). Fugl-Meyer Assessment for upper extremity in stroke: A psychometric systematic review. J. Hand Ther., 1\u201329.","DOI":"10.1016\/j.jht.2025.04.004"},{"key":"ref_9","first-page":"61","article-title":"Functional evaluation: The Barthel Index","volume":"14","author":"Mahoney","year":"1965","journal-title":"Md. State Med. J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1097\/00004356-198112000-00001","article-title":"A performance test for assessment of upper limb function in physical rehabilitation treatment and research","volume":"4","author":"Lyle","year":"1981","journal-title":"Int. J. Rehabil. Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1186\/s12984-024-01491-x","article-title":"Examining the effectiveness of motor imagery combined with non-invasive brain stimulation for upper limb recovery in stroke patients: A systematic review and meta-analysis of randomized clinical trials","volume":"21","author":"Zhang","year":"2024","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"105876","DOI":"10.1016\/j.jstrokecerebrovasdis.2021.105876","article-title":"Effects of motor imagery as a complementary resource on the rehabilitation of stroke patients: A meta-analysis of randomized trials","volume":"30","author":"Monteiro","year":"2021","journal-title":"J. Stroke Cerebrovasc. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"364","DOI":"10.14336\/AD.2016.1012","article-title":"Motor imagery-based rehabilitation: Potential neural correlates and clinical application for functional recovery of motor deficits after stroke","volume":"8","author":"Tong","year":"2017","journal-title":"Aging Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2059","DOI":"10.1161\/STROKEAHA.107.507160","article-title":"Not all stroke units are the same: A comparison of physical activity patterns in Melbourne, Australia, and Trondheim, Norway","volume":"39","author":"Bernhardt","year":"2008","journal-title":"Stroke"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1111\/1440-1630.12084","article-title":"Meta-analysis on the effect of mental imagery on motor recovery of the hemiplegic upper extremity function","volume":"61","author":"Kho","year":"2014","journal-title":"Aust. Occup. Ther. J."},{"key":"ref_16","first-page":"3752889","article-title":"Motor imagery and mental practice in the subacute and chronic phases in upper limb rehabilitation after stroke: A systematic review","volume":"2023","year":"2023","journal-title":"Occup. Ther. Int."},{"key":"ref_17","first-page":"CD005950","article-title":"Mental practice for treating upper extremity deficits in individuals with hemiparesis after stroke","volume":"2020","author":"Barclay","year":"2020","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1097\/NPT.0000000000000200","article-title":"Motor imagery training after stroke: A systematic review and meta-analysis of randomized controlled trials","volume":"41","author":"Guerra","year":"2017","journal-title":"J. Neurol. Phys. Ther."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Polo-Ferrero, L., Torres-Alonso, J., Luis S\u00e1nchez-Gonz\u00e1lez, J., Hern\u00e1ndez-Rubia, S., P\u00e9rez-Elvira, R., and Oltra-Cucarella, J. (2025). Motor imagery for post-stroke upper limb recovery: A meta-analysis of RCTs on Fugl-Meyer upper extremity scores. J. Clin. Med., 14.","DOI":"10.3390\/jcm14217891"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Nakashima, A., Okamura, R., Moriuchi, T., Fujiwara, K., Higashi, T., and Tomori, K. (2024). Exploring methodological issues in mental practice for upper-extremity function following stroke-related paralysis: A scoping review. Brain Sci., 14.","DOI":"10.3390\/brainsci14030202"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1177\/0269215510395793","article-title":"Longer versus shorter mental practice sessions for affected upper extremity movement after stroke: A randomized controlled trial","volume":"25","author":"Page","year":"2011","journal-title":"Clin. Rehabil."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1053\/apnr.2002.34181","article-title":"Popping the (PICO) question in research and evidence-based practice","volume":"15","author":"Stone","year":"2002","journal-title":"Appl. Nurs. Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1016\/S0004-9514(08)70034-5","article-title":"Action Research Arm Test","volume":"54","author":"McDonnell","year":"2008","journal-title":"Aust. J. Physiother."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Ohura, T., Hase, K., Nakajima, Y., and Nakayama, T. (2017). Validity and reliability of a performance evaluation tool based on the modified Barthel Index for stroke patients. BMC Med. Res. Methodol., 17.","DOI":"10.1186\/s12874-017-0409-2"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1186\/s12984-017-0277-3","article-title":"Topographical measures of functional connectivity as biomarkers for post-stroke motor recovery","volume":"14","author":"Philips","year":"2017","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Borenstein, M., Hedges, L.V., Higgins, J.P.T., and Rothstein, H.R. (2009). Introduction to Meta-Analysis, Wiley.","DOI":"10.1002\/9780470743386"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Higgins, J.P.T., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M.J., and Welch, V.A. (2019). Cochrane Handbook for Systematic Reviews of Interventions, Wiley.","DOI":"10.1002\/9781119536604"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: A revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1016\/0895-4356(90)90159-M","article-title":"High agreement but low kappa: II. Resolving the paradoxes","volume":"43","author":"Cicchetti","year":"1990","journal-title":"J. Clin. Epidemiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"159","DOI":"10.2307\/2529310","article-title":"The measurement of observer agreement for categorical data","volume":"33","author":"Landis","year":"1977","journal-title":"Biometrics"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.jphys.2019.08.005","article-title":"Clinimetrics: Physiotherapy Evidence Database (PEDro) Scale","volume":"66","author":"Cashin","year":"2020","journal-title":"J. Physiother."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/S0004-9514(09)70043-1","article-title":"The PEDro scale is a valid measure of the methodological quality of clinical trials: A demographic study","volume":"55","year":"2009","journal-title":"Aust. J. Physiother."},{"key":"ref_34","unstructured":"(2025, September 15). R: The R Project for Statistical Computing. Available online: https:\/\/www.r-project.org\/."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v036.i03","article-title":"Conducting meta-analyses in R with the metafor package","volume":"36","author":"Viechtbauer","year":"2010","journal-title":"J. Stat. Softw."},{"key":"ref_36","unstructured":"(2025, September 15). Weights in Models Fitted with the rma.mv() Function [The metafor Package]. Available online: https:\/\/www.metafor-project.org\/doku.php\/tips:weights_in_rma.mv_models."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1037\/0033-2909.112.1.155","article-title":"A power primer","volume":"112","author":"Cohen","year":"1992","journal-title":"Psychol. Bull."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1002\/jrsm.1424","article-title":"The orchard plot: Cultivating a forest plot for use in ecology, evolution, and beyond","volume":"12","author":"Nakagawa","year":"2021","journal-title":"Res. Synth. Methods"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1002\/sim.1186","article-title":"Quantifying heterogeneity in a meta-analysis","volume":"21","author":"Higgins","year":"2002","journal-title":"Stat. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1037\/1082-989X.11.2.193","article-title":"Assessing heterogeneity in meta-analysis: Q statistic or I2 index?","volume":"11","author":"Botella","year":"2006","journal-title":"Psychol. Methods"},{"key":"ref_41","first-page":"1994","article-title":"Correcting for outcome reporting bias in a meta-analysis: A meta-regression approach","volume":"56","author":"Wicherts","year":"2024","journal-title":"Behav. Res. Methods"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1136\/bjsports-2019-100806","article-title":"Identifying the \u201cincredible\u201d! Part 1: Assessing the risk of bias in outcomes included in systematic reviews","volume":"54","author":"Winters","year":"2020","journal-title":"Br. J. Sports Med."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Page, M.J., Higgins, J.P.T., Clayton, G., Sterne, J.A.C., Hr\u00f3bjartsson, A., and Savovi\u0107, J. (2016). Empirical evidence of study design biases in randomized trials: Systematic review of meta-epidemiological studies. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0159267"},{"key":"ref_44","unstructured":"(2025, September 15). Files Neuropsicolog\u00eda y Envejecimiento|SABIEX: Programa Integral Para Mayores de 55 A\u00f1os en la UMH. Available online: https:\/\/sabiex.umh.es\/lineas-de-investigacion\/neuropsicologia-y-envejecimiento-files\/."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"259","DOI":"10.5958\/0973-5674.2014.00048.3","article-title":"Relative & cumulative efficacy of auditory & visual imagery on upper limb functional activity among chronic stroke patients","volume":"8","author":"Ahmad","year":"2014","journal-title":"Indian J. Physiother. Occup. Ther."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1191\/026921501672063235","article-title":"A randomized efficacy and feasibility study of imagery in acute stroke","volume":"15","author":"Page","year":"2001","journal-title":"Clin. Rehabil."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1293","DOI":"10.1161\/01.STR.0000260205.67348.2b","article-title":"Mental practice in chronic stroke: Results of a randomized, placebo-controlled trial","volume":"38","author":"Page","year":"2007","journal-title":"Stroke"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"2033","DOI":"10.3109\/09638288.2011.556208","article-title":"Visuomotor imagery as a new tool in the rehabilitation of neglect: A randomised controlled study of feasibility and efficacy","volume":"33","author":"Welfringer","year":"2011","journal-title":"Disabil. Rehabil."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1373","DOI":"10.1093\/brain\/awr077","article-title":"Mental practice with motor imagery in stroke recovery: Randomized controlled trial of efficacy","volume":"134","author":"Ietswaart","year":"2011","journal-title":"Brain"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1016\/j.apmr.2010.03.008","article-title":"An integrated motor imagery program to improve functional task performance in neurorehabilitation: A single-blind randomized controlled trial","volume":"91","author":"Dawes","year":"2010","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.1589\/jpts.27.1075","article-title":"Effects of mental practice on stroke patients\u2019 upper extremity function and daily activity performance","volume":"27","author":"Park","year":"2015","journal-title":"J. Phys. Ther. Sci."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"85.e1","DOI":"10.1016\/j.jamda.2010.07.009","article-title":"A multicenter randomized controlled trial to compare subacute \u201ctreatment as usual\u201d with and without mental practice among persons with stroke in Dutch nursing homes","volume":"13","author":"Braun","year":"2012","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1177\/1545968319899919","article-title":"Motor imagery training after stroke increases slow-5 oscillations and functional connectivity in the ipsilesional inferior parietal lobule","volume":"34","author":"Wang","year":"2020","journal-title":"Neurorehabil. Neural Repair"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1111\/cns.14065","article-title":"Motor network reorganization after motor imagery training in stroke patients with moderate to severe upper limb impairment","volume":"29","author":"Wang","year":"2023","journal-title":"CNS Neurosci. Ther."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Liu, W., Cheng, X., Rao, J., Yu, J., Lin, Z., Wang, Y., Wang, L., Li, D., Liu, L., and Gao, R. (2024). Motor imagery therapy improved upper limb motor function in stroke patients with hemiplegia by increasing functional connectivity of sensorimotor and cognitive networks. Front. Hum. Neurosci., 18.","DOI":"10.3389\/fnhum.2024.1295859"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1038\/nrneurol.2010.200","article-title":"Neuroplasticity in the context of motor rehabilitation after stroke","volume":"7","author":"Dimyan","year":"2011","journal-title":"Nat. Rev. Neurol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1152\/jn.00148.2021","article-title":"No evidence for motor-recovery-related cortical connectivity changes after stroke using resting-state fMRI","volume":"127","author":"Branscheidt","year":"2021","journal-title":"J. Neurophysiol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1080\/165019701750165916","article-title":"The responsiveness of the Action Research Arm Test and the Fugl-Meyer Assessment scale in chronic stroke patients","volume":"33","author":"Beckerman","year":"2001","journal-title":"J. Rehabil. Med."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1693","DOI":"10.1016\/j.apmr.2008.02.022","article-title":"Estimating minimal clinically important differences of upper-extremity measures early after stroke","volume":"89","author":"Lang","year":"2008","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1177\/1545968313491000","article-title":"A standardized approach to the Fugl-Meyer Assessment and its implications for clinical trials","volume":"27","author":"See","year":"2013","journal-title":"Neurorehabil. Neural Repair"},{"key":"ref_61","first-page":"453","article-title":"Predicting improvement in the upper paretic limb after stroke: A longitudinal prospective study","volume":"25","author":"Kwakkel","year":"2007","journal-title":"Restor. Neurol. Neurosci."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1272\/jnms.82.4","article-title":"Brain plasticity and rehabilitation in stroke patients","volume":"82","author":"Hara","year":"2015","journal-title":"J. Nippon Med. Sch."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1177\/1545968314543308","article-title":"Predicting the performance of motor imagery in stroke patients: Multivariate pattern analysis of functional MRI data","volume":"29","author":"Park","year":"2015","journal-title":"Neurorehabil. Neural Repair"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1016\/j.apmr.2007.11.006","article-title":"Reliability of mental chronometry for assessing motor imagery ability after stroke","volume":"89","author":"Malouin","year":"2008","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Phan, H.L., Le, T.H., Lim, J.M., Hwang, C.H., and Koo, K.I. (2022). Effectiveness of augmented reality in stroke rehabilitation: A meta-analysis. Appl. Sci., 12.","DOI":"10.3390\/app12041848"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"420","DOI":"10.5535\/arm.2016.40.3.420","article-title":"Virtual reality-guided motor imagery increases corticomotor excitability in healthy volunteers and stroke patients","volume":"40","author":"Im","year":"2016","journal-title":"Ann. Rehabil. Med."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1080\/17483107.2022.2060354","article-title":"The clinical effects of brain\u2013computer interface with robot on upper-limb function for post-stroke rehabilitation: A meta-analysis and systematic review","volume":"19","author":"Qu","year":"2024","journal-title":"Disabil. Rehabil. Assist. Technol."},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Khan, M.A., Fares, H., Ghayvat, H., Brunner, I.C., Puthusserypady, S., Razavi, B., Lansberg, M., Poon, A., and Meador, K.J. (2023). A systematic review on functional electrical stimulation-based rehabilitation systems for upper limb post-stroke recovery. Front. Neurol., 14.","DOI":"10.3389\/fneur.2023.1272992"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1161\/STROKEAHA.116.015501","article-title":"Stroke recovery and rehabilitation research: Issues, opportunities, and the National Institutes of Health StrokeNet","volume":"48","author":"Cramer","year":"2017","journal-title":"Stroke"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/1\/174\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T16:49:05Z","timestamp":1768495745000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/1\/174"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,15]]},"references-count":69,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["medicina62010174"],"URL":"https:\/\/doi.org\/10.3390\/medicina62010174","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,15]]}}}