Researchers from the Medical University of Vienna and ETH Zurich have developed a rehabilitation platform that combines immersive virtual reality (VR) with targeted sensory nerve stimulation to improve recovery after stroke. Early clinical results suggest that the technology not only enhances arm and hand function but also restores sensation and body awareness. These are areas that often receive less attention in conventional rehabilitation.
The proof-of-concept study demonstrated that patients using the platform achieved greater functional improvements than those receiving standard rehabilitation alone. Although larger clinical trials are still needed, the findings point toward a new generation of personalized, data-driven rehabilitation that could eventually extend into patients' homes.
Beyond movement training
Stroke remains one of the leading causes of long-term disability worldwide. While physiotherapy and occupational therapy can significantly improve mobility in the months immediately after a stroke, many patients continue to experience persistent weakness, impaired sensation and difficulties perceiving the position of their affected limb. Traditional rehabilitation primarily focuses on restoring movement. However, researchers increasingly recognize that successful recovery also depends on rebuilding sensory feedback and body awareness, which play a crucial role in controlling movement.
To address this challenge, researchers led by Professor Stanisa Raspopovic from the Center for Medical Physics and Biomedical Engineering at the Medical University of Vienna developed MultiSensy, a rehabilitation platform that combines immersive VR with transcutaneous electrical nerve stimulation.
Patients wear a VR headset while performing interactive tasks that simulate everyday activities such as reaching, grasping, pinching and rotating the forearm. At the same time, electrodes placed on the skin stimulate peripheral nerves in real time, allowing users to experience virtual objects as though they were physically touching them. "Our aim was to go beyond mere movement training," said Raspopovic. "After a stroke, patients often have difficulty not only moving the affected limb, but also feeling it and perceiving it correctly. MultiSensy was developed to reconnect movement, sensation and body awareness during rehabilitation."
Greater improvements
The feasibility study included 34 patients who had experienced a stroke at least three months earlier. Participants in the intervention group completed twelve MultiSensy training sessions over three weeks, while the control group received conventional physiotherapy and occupational therapy.
Patients using the VR platform achieved significantly greater improvements in upper-limb function. On the widely used Fugl-Meyer Assessment for upper extremity recovery, improvements were nearly twice as large as those seen with conventional rehabilitation. Similar gains were observed on the Action Research Arm Test, which measures how effectively patients perform functional hand and arm tasks in daily life.
The technology also appeared to address sensory deficits that often remain after stroke. According to lead author Valerio Aurucci of ETH Zurich, participants showed improvements in tactile perception as well as in their awareness of the affected arm. "After a stroke, some patients struggle to feel touch in their affected hand and may even perceive the arm as distorted in size, shape or position," Aurucci explained. "Participants treated with the new system showed improvements in their sense of touch and in perception of their affected arm."
Personalized rehabilitation
In addition to providing therapy, MultiSensy continuously records movement data during every training session. These objective performance metrics allow clinicians to monitor recovery over time and tailor rehabilitation to each patient's individual progress. The researchers believe this capability could support more personalized rehabilitation programs while reducing dependence on subjective clinical assessments. Because the platform combines digital exercises with automated performance monitoring, it may also lend itself to future home-based rehabilitation models, potentially increasing access to therapy after patients leave hospital.
"The results provide early clinical evidence that immersive virtual reality combined with sensory nerve stimulation can support recovery after stroke, even months after the event," Raspopovic said. Although the technology remains in the research phase, the team believes it represents an important step toward more comprehensive rehabilitation strategies that address not only motor recovery but also the sensory and perceptual impairments that limit independence after stroke.
If confirmed in larger multicenter studies, MultiSensy could become part of a broader shift toward intelligent rehabilitation platforms that combine immersive technologies, wearable sensors and personalized therapy to improve long-term outcomes for stroke survivors.
