Rebuilding Function After Stroke: Emerging Technologies and New Frontiers in Neurological Recovery

Resumen

Stroke remains a major cause of long-term neurological disability worldwide, creating a growing need for rehabilitation strategies capable of promoting functional recovery through intensive, repetitive, task-oriented, and personalized interventions. Digital neurorehabilitation has emerged as a multidisciplinary approach that integrates neuroscience, physical and rehabilitation medicine, neurology, and biomedical engineering through technologies such as virtual reality, robot-assisted rehabilitation, brain-computer interfaces, wearable sensors, artificial intelligence, and telerehabilitation. This review analyzed international scientific evidence regarding the application of these technologies after stroke, with particular attention to their relationship with experience-dependent neuroplasticity, functional outcomes, implementation challenges, and applicability across different healthcare environments, including Latin America. Scientific evidence was identified and critically synthesized from internationally recognized databases, prioritizing randomized controlled trials, systematic reviews, meta-analyses, clinical guidelines, and relevant contemporary studies. The reviewed literature showed that virtual reality and robot-assisted rehabilitation constitute the most extensively investigated technological approaches, with favorable findings particularly in upper-limb motor function, balance, gait, functional mobility, and activities of daily living. Telerehabilitation and wearable technologies provide additional opportunities for extending therapeutic continuity and objective monitoring beyond specialized rehabilitation facilities, while brain-computer interfaces and artificial intelligence represent emerging approaches for neural feedback and personalized rehabilitation. Despite these advances, considerable heterogeneity remains regarding intervention protocols, technological platforms, therapeutic intensity, outcome measures, and patient characteristics. Furthermore, acquisition costs, infrastructure requirements, professional training, accessibility, connectivity, and digital literacy continue to influence implementation, particularly in resource-constrained healthcare systems. Current evidence supports digital technologies as complementary components of multidisciplinary stroke rehabilitation rather than substitutes for conventional therapy. Future research should prioritize standardized protocols, multicenter studies, long-term functional outcomes, cost-effectiveness, equitable accessibility, and greater representation of Latin American populations to advance toward evidence-based precision neurorehabilitation.