Motivation in motor training interventions after stroke-a systematic review

Area of Science:

• Neurorehabilitation
• Motor Recovery
• Psychology of Rehabilitation

Background:

• Motivation is crucial for successful rehabilitation after stroke.
• Therapeutic interventions targeting motor improvement should also consider motivational effects.

Purpose of the Study:

• To systematically review therapy interventions for motor improvement post-stroke that have also assessed motivational effects.
• To identify which interventions show potential for enhancing both motor performance and patient motivation.

Main Methods:

• A comprehensive literature search was conducted in August 2025 across CINAHL, MEDLINE, Embase, and PEDro.
• Included were randomized controlled trials reporting outcomes for both motor performance and motivation, adhering to PRISMA guidelines.
• Seventeen trials with 521 stroke survivors were included, with a high risk of bias noted due to blinding limitations.

Main Results:

• Motivation was infrequently measured across the included studies.
• Exergaming was the most studied intervention, alongside animal-assisted therapy, smart technology, and boxing.
• Four exergame trials and one animal-assisted therapy trial reported positive effects on both motivation and motor performance.

Conclusions:

• Evidence linking motor interventions post-stroke to motivation is currently limited.
• Exergames demonstrate potential for motivating stroke patients and improving motor function, though mechanisms require further investigation.
• Social interaction, as seen in animal-assisted therapy, is another promising area for enhancing rehabilitation outcomes.