Oral Presentation Australian and New Zealand Stroke Organisation Conference 2026

Enhancing motor training after stroke: A systematic review and meta-analysis of adjuvant interventions in translational studies (138846)

Madeleine J. Smith 1 , Jean-Louis Zhao 2 , Ana Antonic-Baker 1 , Lauren J. Christie 3 4 5 , Andrew N. Clarkson 1 6 , Dale Corbett 7 , Numa Dancause 2 , Kathryn S. Hayward 8 , Xingyue He 1 , Brendan McCarthy 1 , Matthew Wingfield 8 , Natasha A. Lannin 1 9
  1. Department of Neuroscience, Monash University, Melbourne, Victoria, Australia
  2. Département de Neurosciences, Centre Interdisciplinaire de Recherche sur le Cerveau et l’Apprentissage (CIRCA), Université de Montréal, Montréal, Canada
  3. Allied Health Research Unit, St Vincent’s Health Network Sydney, Darlinghurst, NSW, Australia
  4. School of Allied Health, Faculty of Health Sciences, Australian Catholic University, North Sydney, NSW, Australia
  5. Nursing Research Institute, St Vincent’s Health Network Sydney, St Vincent’s Hospital Melbourne and Australian Catholic University, Darlinghurst, NSW, Australia
  6. REGENBIO Consultants LTD, Dunedin, New Zealand
  7. Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Canada
  8. Department of Physiotherapy, University of Melbourne, Melbourne, VIC, Australia
  9. Bayside Health, Alfred Care Group, Melbourne, VIC, Australia

Background/Aims: Many stroke survivors live with permanent upper limb disability. While motor training improves strength, coordination, and limb use, recovery may be further enhanced by adjuvant therapies that promote a neuroplastic environment. This systematic review aimed to determine if task-specific forelimb motor training either alone or in combination with other interventions, improves performance in forelimb motor tasks or enhances generalised motor recovery after ischaemic stroke in animal models.

Method: Searches were conducted in PubMed, MEDLINE, Embase and Web of Science. Two authors independently screened titles and abstracts, reviewed full-texts and extracted data.

Results: Fifty-nine studies were included, most were conducted in rats (n=49, 83%) using predominantly male animals (n=46, 78%) with endothelin-1 (n=31, 53%) and photothrombosis (n=18, 31%) models most common. Adjuvants were evaluated in 68% of studies and included cortical stimulation, vagus nerve stimulation, and pharmacological, behavioural, and molecular therapies. Motor training improved performance in the single pellet reaching task (SMD 1.53, p<0.00001) and pasta matrix reaching task (SMD 0.79, p=0.0001), but not performance on the staircase (reaching), cylinder (spontaneous forelimb use), or grid/ladder walking tests (locomotion and limb placement). Cortical stimulation, enriched environment, and dietary interventions significantly improved reaching performance compared to motor training alone.

Conclusion: Emerging adjuvants (e.g. cortical stimulation, enriched environment) show promise as translational candidates to enhance post-stroke recovery. Clinically, there is growing interest in combining adjuvants with motor training. These findings identify promising candidates to inform future clinical trial design.