Treatment techniques for improving upper extremity function in chronic stroke patients (2020–2025): a narrative review

Abstract Stroke is a major cause of long-term disability, and chronic upper extremity (UE) impairment is a significant constraint to independence and quality of life in stroke survivors. The narrative review is developed on the basis of the synthesis of the available studies in 2020–25 and is constructed on Scopus, PubMed, Web of Science, Nature, physiotherapy journals, Google Scholar, and ResearchGate. The review takes into account the effectiveness of significant rehabilitation interventions, including virtual reality (VR), robot-assisted therapy, functional electrical stimulation (FES), task-oriented training (TOT), noninvasive brain stimulation (NIBS), functional strength training (FST). The results suggest that VR can be more effective in terms of motor recovery and patient interaction, and robot-assisted therapy can be more effective in combination with physiotherapy. FES shows improvements in functional performance and spasticity and TOT in task-specific performance. NIBS outcomes are rather inconsistent, and transcranial direct current stimulation (tDCS) is linked to more positive outcomes than transcranial magnetic stimulation (TMS). FST is one more technique, the beneficial effects of which on strength and daily performance are permanent. In general, multimodal and patient-specific interventions seem to have the best chance of success and standardized protocols and multicenter trials, as well as cost-effective mechanisms to make them more widespread, are required.