NeuroRehab Team
Thursday, June 19th, 2025
Electrical Stimulationvagus nerve stimulation
Vagus Nerve Stimulation (VNS) uses a small, surgically implanted pulse generator placed under the chest skin. Electrodes connect to the vagus nerve in the neck. When patients perform targeted arm or hand movements, the device delivers precise electrical pulses. As a result, it activates the brain’s learning pathways and reinforces motor circuits.
NeuroRehab Team
Tuesday, June 17th, 2025
Functional Electrical Stimulation (FES) and task-specific training are both proven approaches to improving outcomes after stroke. When used together, they provide a powerful framework for motor recovery, neuroplasticity, and functional independence.
NeuroRehab Team
Thursday, June 12th, 2025
In stroke rehabilitation, the instinct is often to minimize mistakes. But what if amplifying them could actually accelerate recovery?
Enter Error Augmentation Training (EAT)—an innovative approach that exaggerates movement errors to retrain the brain. By leveraging neuroplasticity and real-time feedback, EAT encourages stroke survivors to actively correct deviations, promoting faster and more effective motor recovery.
NeuroRehab Team
Tuesday, June 10th, 2025
Early rehabilitation is critical after stroke—and motorized arm cycling is emerging as a highly effective intervention. By combining guided, repetitive movement with muscle activation, this approach strengthens motor recovery, reduces complications, and improves functional outcomes.
NeuroRehab Team
Sunday, June 8th, 2025
Attention is a finite cognitive resource that becomes especially vulnerable when other systems falter. Across neurological and systemic conditions, the brain often compensates for deficits in processing, sensation, or memory by reallocating attentional resources—leading to fatigue, errors, and cognitive overload.
NeuroRehab Team
Saturday, June 7th, 2025
Neuroplasticity underpins the central nervous system’s ability to reorganize and recover. Understanding these primary mechanisms enables clinicians to develop targeted interventions that support functional restoration and learning.
NeuroRehab Team
Saturday, June 7th, 2025
Occupational therapists (OTs) are pivotal in vision rehabilitation, focusing not on surgical eye correction but on improving functional performance in daily life.
NeuroRehab Team
Wednesday, August 28th, 2024
Biofeedback is a powerful therapeutic technique that provides patients with real-time information about their physiological processes, empowering them to actively monitor and regulate their own bodily functions. Yet, despite its proven benefits, biofeedback remains significantly underutilized in the therapy world. In this comprehensive article, we’ll explore the reasons behind this underutilization and uncover the compelling advantages that make biofeedback a must-have tool in every therapist’s arsenal.
NeuroRehab Team
Thursday, May 11th, 2023
This AOTA approved continuing education class will introduce you to efficacous evidence-based interventions that drive neuroplastic change resulting in improved balance following neurological injury.
NeuroRehab Team
Friday, March 10th, 2023
Salia Rehab is proud to be an AOTA Approved Provider of high-quality professional development.
Course Approval ID: #6686
This online, self-paced activity offers 0.125 CEUs (1.25 contact hours) and is designed for occupational therapists, physical therapists, assistants, physicians, and other rehab professionals who directly treat clients recovering from stroke.
Please note: The assignment of AOTA CEUs does not imply endorsement of specific course content, clinical methods, or products by AOTA, nor does it indicate AOTA’s approval of a certification or other professional recognition.
This evidence-based online CEU will teach you the most effective interventions proven to promote neuroplasticity and restore meaningful hand and arm function after a stroke. You’ll learn practical techniques to break learned nonuse, encourage active movement, and help patients maximize recovery.
Participants have 90 days to complete this intermediate-level course and must achieve an 80% passing score on the quiz to earn their certificate.
👉 Click here to register for Stroke Hand Simplified and gain practical, evidence-based strategies you can apply immediately.
NeuroRehab Team
Friday, March 3rd, 2023
Suffering from a neurological injury such as stroke can be a long and hard battle. Having the right team in place can make a significant impact on the success of one’s recovery. Being comfortable with one’s clinical team can set patients up for great success. Health professional building that immediate trust is key to a positive outcome.
NeuroRehab Team
Friday, January 13th, 2023
Arm and HandElectrical StimulationHand Function SplintsMental PracticeMirror TherapyNeuroplasticityStroke Statistics
Every 2.1 seconds, someone in the world suffers a stroke. Stroke is the #1 cause of long-term disability worldwide. Globally, there are over 15 million stroke survivors. With respect to the United States, there are approximately 5.1 million stroke survivors alive today in the US. It is the third leading cause of death in USA and the numbers are expected to double by 2030.
NeuroRehab Team
Wednesday, December 28th, 2022
This AOTA approved online self-study continuing education class will introduce you to evidence-based practice surrounding Constraint-Induced Movement Therapy to the stroke population.
The online class is intended for medical professionals (e.g. OT/OTA, PT/PTA, Physicians, etc.) directly related to the rehabilitation of a patient or client. To participate in this CEU and receive credit, the participant must be a licensed, treating clinician. Completion of this course will reward the participant with .1 CEUs or 1 contact hour, following completion of the presentation and a ≥80% score on the quiz. You will have 90 days to complete this course.
NeuroRehab Team
Monday, December 26th, 2022
This AOTA approved online self-study continuing education class will introduce you to evidence-based practice surrounding electrical stimulation to the stroke population.
The online class is intended for medical professionals (e.g. OT/OTA, PT/PTA, Physicians, etc.) directly related to the rehabilitation of a patient or client. To participate in this CEU and receive credit, the participant must be a licensed, treating clinician. Completion of this course will reward the participant with .1 CEUs or 1 contact hour, following completion of the presentation and a ≥80% score on the quiz. You will have 90 days to complete this course.
NeuroRehab Team
Wednesday, December 21st, 2022
“Would you rather spend most of your time learning compensatory one-handed strategies with your unaffected side, or would you rather focus on improving strength, range of motion and function in your affected limb?” That’s a big question.
NeuroRehab Team
Thursday, December 8th, 2022
NeuroRehab Team
Friday, December 2nd, 2022
Robot-assisted therapy has become increasingly popular over the last 2 decades. In fact, it is so well-known that out of the 1,300 RCT’s in UE stroke recovery, robotic research leads the pack with 112 RCT’s! There is no doubt robotic therapy, in some form or fashion, is here to stay, however is it a MUST-HAVE or a NICE-TO-HAVE intervention?
NeuroRehab Team
Saturday, November 26th, 2022
Shoulder pain resulting from stroke hemiplegia is a common clinical consequence. Hemiplegic shoulder pain can occur as early as two weeks post-stroke but an onset of two to three months is more typical. Frozen shoulder, pain and weakness can negatively affect rehabilitation outcomes as good shoulder function is a prerequisite for successful transfers, maintaining balance, effective hand function, and performing ADL’s activities of daily living.
NeuroRehab Team
Wednesday, November 23rd, 2022
Great question—and the answer is ABSOLUTELY!
For many clinicians, the idea of strengthening spastic or hyperactive muscles in stroke survivors has long been controversial. The thought of asking a patient to squeeze a spastic hand or flex a tight bicep can make some therapists cringe. Historically, such interventions were discouraged, often based on tradition and outdated clinical beliefs rather than scientific evidence.
Early in their careers, many therapists were advised not to “trigger abnormal movement patterns” in patients with hemiparesis. Strengthening hyperactive muscles was thought to increase spasticity, reinforce abnormal synergies, and even cause pain. But this guidance was based on anecdote, not data—passed down from one generation of clinicians to the next, without being questioned.
The reality is this: these warnings had no research backing them. They were based on assumptions and fear, not evidence.
Fast-forward to today, and a wealth of research supports strength training for individuals with spastic hemiparesis. According to the Evidence-Based Review of Stroke Rehabilitation (EBRSR), 33 randomized controlled trials (RCTs) have evaluated strength training for upper extremity motor recovery. The findings? Strength training is beneficial—and none of the studies concluded that it increased spasticity or pain.
In fact, strengthening programs were associated with improved function, greater independence, and better motor outcomes. As with all therapy, dosage and technique matter, but the research overwhelmingly supports strength training as a safe and effective intervention post-stroke.
The neurorehabilitation landscape has shifted dramatically over the past two decades. We’ve moved away from concepts like:
And we’ve embraced interventions supported by science, such as:
Studies by Patten, Butefisch, Sharp, Teixeira-Salmela, and Wolf have all demonstrated the benefits of these modern strategies. These techniques don’t just improve strength—they promote true neuroplastic change and real-world functional gains.
One of the most important shifts in perspective has been recognizing that muscle weakness—not spasticity—is often the primary barrier to movement. While spasticity can create resistance, studies show that focusing on reducing tone alone does not lead to improved function. On the other hand, targeting strength deficits often leads to better control, improved coordination, and enhanced use of the affected limb.
Research by Harris, Ada, and Patten supports this modern approach: treat weakness first.
Occupational therapy has come a long way. As the profession celebrates more than 100 years of evolution, AOTA’s Centennial Vision continues to ring true: “Occupational therapy is a powerful, science-driven, and evidence-based profession.” And nowhere is that more evident than in the ongoing transformation of stroke rehabilitation practices.
As we adopt smarter technology, more robust clinical trials, and modern protocols, we empower therapists and stroke survivors alike to pursue outcomes that were once thought impossible. The goal is no longer just compensating—it’s recovering.
Strengthening spastic muscles after stroke is not only safe—it’s necessary. The evidence is clear, and the tools are available. Let’s continue to challenge outdated ideas, embrace evidence-based care, and give every stroke survivor the opportunity to achieve their fullest potential.
NeuroRehab Team
Saturday, November 19th, 2022
Stroke recovery is a hard and long journey for most patients. There are therapists that “treat neuro patients” and then there are “neuro therapists”. In order for a patient to reach maximum potential with their rehab journey, they will need a clinician that understands, appreciates and knows the neurorecovery process.
NeuroRehab Team
Friday, November 18th, 2022
Hand Function SplintsNeuroplasticity
Just like athletes and musicians, many stroke survivors will have periodic and temporary plateaus or setbacks as they continue to improve. It is a back-and-forth process. Improve a little, then a plateau occurs. Modify the training and improve some more. Then, here comes another plateau. Modify again. You get the idea.
NeuroRehab Team
Wednesday, November 16th, 2022
Occupational Therapy (OT) CEU’s are part of the necessary requirements to maintain one’s license. In addition, a clinician may seek out paid or free continuing education classes (CEU) to advance his or her knowledge and skill set.
NeuroRehab Team
Monday, November 14th, 2022
Mental PracticeMirror TherapyNeuroplasticitypriming
Priming the Brain Works.
Better clinical outcomes following stroke are associated with interventions such as cortical priming resulting in increased excitability of the motor cortex (Catano et al).
Priming is a technique used to enhance the brain’s ability to re-balance the 2 hemispheres following a stroke. Priming interventions include invasive and non-invasive techniques and can be administered prior to or during therapy.
NeuroRehab Team
Friday, November 4th, 2022
Electrical Stimulationshouldersubluxation
The shoulder is the most complicated joint in the human body. It’s also one of the most difficult aspects of recovery for hemiplegic stroke survivors.
Why?
NeuroRehab Team
Friday, October 28th, 2022
Mental PracticeNeuroplasticity
Before each race, Michael Phelps, the 28-time Olympic medalist, would sit quietly and perform mental reps, imagining his performance step-by-step.
NeuroRehab Team
Friday, October 14th, 2022
Stroke survivors are beautiful and handsome heroes. But it’s not about vanity – it’s about recovery. Mirror Therapy (MT) is a critical intervention – yet vastly underutilized.
NeuroRehab Team
Friday, October 7th, 2022
The human brain is one of the most fascinating and complex organs in the body. It houses over 100 billion neurons and forms more than 200 trillion synaptic connections. During a stroke, approximately 32,000 neurons die every second, totaling nearly 1.2 billion neurons lost in a typical event. While this may sound catastrophic, it represents only about 1% of the brain’s total neurons.
That means 99% of the brain remains intact. And with the right approach, it can compensate, adapt, and heal.
In the 1980s, renowned neuroscientist Dr. Michael Merzenich helped prove that the adult brain is not hardwired—contrary to what many believed. His groundbreaking work revealed that the brain is capable of reorganizing itself by forming new neural connections, a phenomenon known as neuroplasticity.
This discovery has completely shifted our understanding of stroke rehabilitation. Rather than focusing on what was lost, modern therapies focus on what can be rewired.
Unfortunately, many conventional stroke rehab models abandon patients too early—long before neuroplasticity has had a chance to take hold. Standard clinical tests may not detect subtle signs of brain rewiring, such as micro-movements or emerging motor patterns.
As a result, therapy may be prematurely deemed ineffective, when in fact, the brain is just beginning to change. This is one of the greatest oversights in traditional care.
If you’re a clinician, ask yourself: “What did I do in today’s 45-minute session to truly drive neuroplasticity?” The typical therapy session includes only about 30 repetitions. Research suggests that it takes at least 300–400 quality reps per session to begin meaningful rewiring of the brain.
Consider sports training, music practice, or skill development. A baseball pitch, a piano scale, or an ice-skating spin takes thousands of reps to master. Stroke rehab is no different. Every repetition leaves a neurological footprint—a pathway for the next rep to follow. Over time, these paths become stronger, faster, and more automatic.
With today’s evolving technology and research-backed tools, we must challenge traditional concepts that no longer serve patients. Many old-school therapy methods—especially those unsupported by evidence—need to make way for protocols that prioritize repetition, engagement, and science-based strategies.
Therapists must be bold enough to ask, “Is this intervention truly helping my patient move forward?” If not, it’s time to pivot.
Whether you’re a stroke survivor, a caregiver, or a rehab professional, we highly recommend exploring Dr. Merzenich’s book: Soft-Wired: How the New Science of Brain Plasticity Can Change Your Life. It offers an accessible and inspiring look at how neuroplasticity works and what it means for recovery.
Rewiring the brain doesn’t happen overnight. It takes effort, consistency, and intelligent therapy. But it does happen—one rep at a time.
If you’re ready to embrace evidence-based therapy that unlocks the brain’s potential, make sure your approach is grounded in science, driven by repetition, and focused on lasting functional gains.
NeuroRehab Team
Sunday, August 22nd, 2021
Falls can happen anytime and anywhere to people of any age. However, as people get older, or suffer neurological injuries such as stroke, the number of falls and the severity of injury resulting from falls increases. Taking precautions to prevent falling after stroke can help save a life. Falling is the leading cause of accidental home deaths, and they are a major reason for 40% of admissions to nursing homes.
NeuroRehab Team
Saturday, June 26th, 2021
Constraint-Induced Movement Therapy (CIMT) is a form of treatment designed to decrease the impact of a stroke on the upper-limb (UL) function of some stroke survivors. It is a behavioral approach to neurorehabilitation[2] based on “Learned- Nonuse”.
NeuroRehab Team
Friday, January 22nd, 2021
National Institutes of Health Stroke Scale (NIHSS) is a clinical tool that measures stroke-related neurologic deficits. This measure can be quantified. NIHSS is used in modern neurology for three main objectives;
NeuroRehab Team
Wednesday, December 23rd, 2020
Stroke is among the leading causes of severe long-term disabilities. It reduces mobility in more than 50% of its patients who are aged 65 and above. According to NINDS, 15-30% of patients develop a permanent physical disability while most patients regain their hands and legs’ functionality. Symptoms associated with stroke vary from dizziness, fatigue, blurred vision, slurred speech, fatigue, and numbness. However, according to a survey done, only 38% of the respondents knew the stroke’s significant symptoms. The most recognized sign by 98% of the respondents was numbness on one side. Knowing these symptoms is crucial because it can reduce disability in patients. Those who start receiving treatment three hours after the first symptom show less disability than those who receive delayed care.
Lynette Diaz, COTA/L
Tuesday, June 9th, 2020
How many repetitions does it take to create changes in the brain? How many repetitions must one complete before movement is strong, volitional and functional? Research indicates the number is high and the answer is more complex than we may think. Factors to be considered are, quality of repetitions, attention during repetitions, number of joints involved in movement, area of injury in the brain to name a few. It would stand to reason the more complex a movement is the more repetitions would be required.
Lynette Diaz, COTA/L
Monday, June 8th, 2020
Attitude of Gratitude.
After experiencing a traumatic injury such as a stroke, it may be hard for many people to perceive daily things in a positive light. After all, life is not what it was before. Many stroke survivors go from an independent lifestyle to depending on a loved one. It is evident to see how there is not much room for positive thought.
NeuroRehab Team
Wednesday, February 19th, 2020
Arm and HandContracture SplintElectrical StimulationHand Function SplintsMental PracticeMirror TherapyNeuroplasticityStretchingSubluxation Slings
You are eager to return to your normal life, so you are ready to learn more about the typical timeline for recovery after a stroke. Keep reading to get some answers to common questions:
NeuroRehab Team
Saturday, January 25th, 2020
Electrical StimulationFoot Drop BraceLegMobilityNeuroplasticity
A stroke can impact any number of life skills. But the ability to walk can be one of the most significant. Many people identify walking as an important goal after they experience a stroke. This makes sense because walking is related to so many daily routines. Every stroke survivor is different. Some stroke survivors might need help to walk a few feet. Other individuals might recover significantly and be able to walk long distances. This article will provide post-stroke walking education for a range of skill levels.
NeuroRehab Team
Tuesday, January 14th, 2020
Exercise AidsFine Motor CoordinationStrengthening
Launching a hand exercise program begins with understanding how a stroke that happens in your brain can cause problems with your hand. A stroke is basically an injury to the brain due to limited blood flow. The symptoms in the body reflect the area of injury in the brain. So a stroke survivor with hand issues, experienced an injury to the area of the brain that controls the hand.
NeuroRehab Team
Thursday, December 26th, 2019
Sleep Apnea is a known risk factor for stroke and new research suggests that curbing the condition might also aid the recovery of people who’ve suffered a stroke or mini-stroke. New research shows that, among stroke patients, “treatment of sleep apnea with CPAP therapy provides significant benefits, even greater than the benefits of tPA, the FDA-approved drug treatment for stroke,” said study lead researcher Dr. Dawn Bravata.
NeuroRehab Team
Wednesday, December 25th, 2019
When suffering from a brain injury such as stroke, a sense of hopelessness, frustration and vulnerability can occur. Don’t be alone on your journey to recovery! Below are excellent books that provide immense insight into stroke recovery. Click on any of the links for more information.
NeuroRehab Team
Monday, December 23rd, 2019
Getting oneself dressed is a critical part of being a fully independent person. For a person who has had a stroke, getting dressed can help feel more normal again. This can really help to boost both mood and self esteem.
The tips below will help both the stroke patient and the caregiver make dressing an easier part of the daily routine:
Lynette Diaz, COTA/L
Monday, December 23rd, 2019
Stretching can be a very important part of recovery especially following a stroke, when feeling, sensation and movement are returning to a previously flaccid limb. However, is it possible to stretch too much or too hard? Yes it is.
Clinicians frequently see patients handle their affected limbs rather aggressively in an effort to “make it move” or “get it loose”, often stretching their fingers, wrist, elbows and shoulders too far too fast. This may partly be due to lack of sensation or awareness.
NeuroRehab Team
Saturday, December 21st, 2019
Stroke survivors often struggle to regain full use of their affected side. Below are a just a few of the available products on Amazon that can help with improving more recovery at home. Whether you are hoping to improve your arm and hand strength or looking for better results with your walking and endurance, the good news is that you can find excellent products for very low prices. Just take a look below and click for more information.
NeuroRehab Team
Thursday, December 19th, 2019
Adaptive equipment helps stroke patients experience greater independence with everyday life skills or activities of daily living. There is a plethora of assistive devices for all areas of self care including dressing, bathing, grooming, cooking, feeding, toileting, and mobility aids.
NeuroRehab Team
Tuesday, December 10th, 2019
Decreased balance is a common area affected by stroke. Many patients are prone to falling which could lead to serious injuries. Studies have shown that stroke survivors are twice as likely to fall following a stroke and more than three times as likely as the general population to fall multiple times. About 40 percent of stroke survivors have serious falls within a year of their stroke.
Dorothee Zuleger, MOT, OTR/L, DRS
Thursday, November 21st, 2019
Following a stroke, abnormal muscle tone is a common complication. A single muscle or a muscle group may become completely paralyzed. This is known as hypotonic or flaccid or a muscle may increase in muscle tone. This is known as hypertonic or spastic. This abnormal tone usually occurs in the side of the body opposite to the side of the brain lesion.
NeuroRehab Team
Saturday, November 2nd, 2019
When a stroke patient returns home, the home environment can impact a person’s recovery. The home includes the social and cultural environment such as the people who live there, as well as the physical aspects of the home such as steps and layout. It is important that the home environment be one that supports continuing recovery and safety for the patient. This article is intended to provide basic information to stroke survivors and their families about potential problems with the physical aspects of the kitchen.
NeuroRehab Team
Friday, October 25th, 2019
Stroke can cause muscle weakness and tightness along one side of the body. Muscle weakness affects how well you move your body. Without continuous movement daily, your muscles, joints and ligaments will become gradually stiff eventually leading to a contracture.
Search Contracture Foot and Ankle Splints
The ankle and foot is one of the common areas affected by stroke. Often times, foot drop occurs which causes the foot not to clear and lift when walking, which could lead to a risk of falls. When suffering from foot drop, you may experience ankle stiffness over time.
NeuroRehab Team
Wednesday, October 9th, 2019
Individuals suffering from neurological injuries, such as brain injury or stroke, typically develop many side effects including, but not limited to, physical weakness, decreased sensation, cognitive and speech impairments and balance just to name a few. Over the past 2 decades, neurological rehabilitation strategies have shifted more from theory-based treatment to evidence-based (science driven) treatment.
Lynette Diaz, COTA/L
Friday, October 4th, 2019
Sleep is an extremely important component to achieve optimal brain health and function. Poor sleep has been implicated in affecting heart function, blood sugar regulation and cognitive decline. Good sleep and normal sleep-wake cycles have been linked to improved cognitive recovery following neurologic insult to the brain such as in the case of both traumatic and non-traumatic brain injury, stroke, multiple sclerosis and parkinson’s. Typically after a neurological insult the normal sleep-wake cycle is disrupted, with the brain injured patient sleeping throughout the night and day with intermittent periods of wakefulness.
NeuroRehab Team
Friday, August 16th, 2019
While in therapy, it is not uncommon for patients and family members to enhance their rehab vocabulary from daily conversations with the clinical team. From the early moments of their arrival, they are immediately bombarded with clinical “whatchamacallits” from physicians, nurses, and therapists. Although the learning curve can be quite challenging, for many it is achievable thanks to Google and Yahoo.
Unfortunately, once the clinical jargon is finally mastered, the patients are preparing for their discharge date that is typically around the corner. It is not until their discharge week that they begin to have serious discussions with their occupational and physical therapists about what exercises to do at home and various equipment that might be needed.
NeuroRehab Team
Tuesday, August 13th, 2019
Suffering a stroke is a life-changing event. The statistics show that many patients will struggle from long-term impairments well after discharge from the hospital. In addition, a majority of stroke survivors will require ongoing rehabilitation on an outpatient basis so continued progress can be made.
As if learning to adjust to a new life following an injury is not difficult enough, finding a good therapist can be challenging. Like every profession, some individuals are hard working, passionate and extremely knowledgeable about their respective industry, while others seem to live day-to-day in an alternate universe lacking basic skills, motivation and common sense. When your recovery is in the hands of a therapist, it is absolutely critical that you identify the best possible clinician that checks all of your boxes so maximum progress can be made.