Motor Imagery Added to Robot-Assisted Hand Rehabilitation After Stroke

Loss of upper extremity and particularly hand function after stroke reduces independence in daily activities such as eating, dressing, and personal care. Robot-assisted hand rehabilitation provides repetitive, intensive, and task-oriented practice that supports motor learning, dexterity, and functional hand use. Motor imagery, the mental rehearsal of a movement without physically performing it, is thought to activate motor-related brain networks and to support motor learning and neuroplasticity. Evidence on the added value of combining motor imagery with robot-assisted hand rehabilitation for activities of daily living is limited. This randomized controlled trial will investigate whether motor imagery training added to robot-assisted hand rehabilitation produces greater improvement in activities of daily living than robot-assisted hand rehabilitation alone in individuals with stroke. Forty participants will be randomly allocated to an experimental group (robot-assisted hand rehabilitation plus motor imagery, n=20) or a control group (robot-assisted hand rehabilitation alone, n=20). Both groups will receive the same dose of robot-assisted hand rehabilitation with a soft robotic hand rehabilitation glove, three days per week for six weeks. Outcomes will be assessed at baseline and after the six-week program.