Neuroplasticity After Stroke: Clinical Evidence and Its Implication for Effective Rehabilitation Strategies

Stroke remains a major cause of long-term disability as it often leads to persistent motor deficits, which hinder functional recovery. Neuroplasticity is an important driver of poststroke recovery as it supports synaptic remodeling, network reorganization, and activity-dependent adaptation. This review outlines the neurobiological mechanisms of recovery, including Hebbian and homeostatic plasticity. It also discusses how intensive, task-specific rehabilitation leverages these processes. Technological innovations, such as robotic-assisted rehabilitation and sensor-based feedback, further enable high-dose, repetitive, and personalized training. In addition, adjunctive strategies, including pharmacological modulation, noninvasive brain stimulation, and stem cell therapies, which aim to enhance neuroplasticity, are highlighted. Despite their promise, these interventions show inconsistent efficacy, indicating the need for individualized approaches tailored to lesion characteristics, neurophysiological markers, and recovery stage. Future directions should emphasize the integration of biomarkers, neuroimaging, and precision neurotechnologies, together with multimodal combination therapies. These efforts are essential to establish adaptive rehabilitation protocols that can enhance both the consistency and the magnitude of functional recovery.