Table 2. Systematic reviews regarding the effectiveness of selected therapies used in post-stroke rehabilitation.

Therapy	Goal of Therapy			Included Studies/no of Participants	Results		Refs.
Aerobic Exercise (AE)	mobility in long-term stroke survivors			9/680	AE may improve mobility long after a stroke. AE combined with physiotherapy, improves walking capacity and gait speed		[70]
	Brain-Derived Neurotrophic Factor (BDNF)			11/303 2/40 (stroke)	AE may contribute to increased levels of BDNF in neurological populations		[71]
	neuroplasticity outcomes: neurotrophic factors (BDNF, IGF-I, and NGF), neuronal morphology (synaptic and dendritic change), and cortical reorganization			30 (human and animal studies)	Forced AE at moderate to high intensity increases BDNF, IGF-I, NGF, and synaptogenesis in multiple brain regions at least in animal models of stroke		[72]
	aerobic capacity and physical functioning within six months after stroke			11/423	AE early after stroke enhances aerobic capacity by improving VO2peak and walking distance in moderately to mildly affected individuals (robust evidence)		[73]
	indicators of health, functioning and quality of life			25	AE of moderate to high intensity is effective in improving aerobic fitness, maximal walking speed and walking endurance		[74]
	neuroprotection and brain repair			47 (animal models)	Early-initiated (24-48h post-stroke) moderate forced exercise reduce lesion volume and protected perilesional tissue against oxidative damage and inflammation at least for the short term (4 weeks)		[75]
Repetitive task training (RTT)	upper limb function/reach and lower limb function/balance activities of daily living, global motor function, quality of life/health status and adverse events			33/1853	RTT improves arm function, hand function and lower limb functional measures (low-quality evidence) as well as walking and functional ambulation (moderate-quality evidence) up to six months post treatment Insufficient evidence for the risk of adverse events		[68]
Constraint-induced movement therapy (CIMT)	upper limb function			42/ 1453	Limited improvements in motor impairment and motor function, without convincingly reducing disability		[76]
Muscle strengthening	improvement of strength, balance and walking abilities			10/355	Progressive resistance training seemed to be the most effective treatment to improve strength the lower limb, walking distance, fast walking and balance. Training should be intensive and tailored to the patients’ needs		[77]
Electromechanical and robot-assisted training	activities of daily living, arm function, and arm muscle strength			45/1619	Therapy might improve activities of daily living, arm function, and arm muscle strength High quality of the evidence, but high heterogeneity of therapies		[78]
	gait			36/1472	Electromechanical-assisted gait training with physiotherapy is more effective in achieving independent walking than training without these devices Training is the most effective in the first three months after stroke and for patients unable to walk		[79]
Mirror therapy	motor function and motor impairment after stroke, activities of daily living, pain, visuospatial neglect			62/1982	Significant positive effect on motor function, motor impairment and improvement in activities of daily living (moderate-quality evidence) Significant positive effect on pain (low-quality evidence) No clear effect for improving visuospatial neglect		[80]
		balance, gait, and motor function	17/633		Large effect for gait speed improvement Small positive effect for mobility and lower extremity motor recovery. No effect for balance capacity	[81]
Non-Invasive Brain Stimulation (NIBS) including: transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS		NIBS for hemispatial neglect	10/226		NIBS combined with other therapies has positive effect on hemispatial neglect and performance in ADL (moderate-quality evidence) Both excitatory and inhibitory stimulations are effective.	[82]
		NIBS for gait speed	10/226		NIBS combined with other therapies are effective to improve gait speed (moderate-quality evidence)	[83]
		NIBS for paretic limb force production	23		Improvements in paretic limb force after tDCS and rTMS Positive effects on force production by increasing cortical activity in the ipsilesional hemisphere and decreasing cortical activity in the contralesional hemisphere.	[84]
		tDCS for function and activities of daily living	32/748		Very low to moderate quality evidence of the effectiveness of tDCS (anodal/cathodal/dual) versus control (sham/any other intervention) for improving ADL performance after stroke.	[85]
Virtual reality (VR) Virtual reality		UL function, gait, balance, motor function	72 /2470		VR as an adjunct therapy may be beneficial for in improving UL function and ADL Insufficient evidence for gait speed, balance, participation and quality of life	[86]
		ICF domains (Body Structures, Body Functions, Activity, and Participation)	54/1811		Positive effect in Body Function and Body Structure. Inconclusive effect in the domains Activity and Participation	[87]
Neuromuscular electrical stimulation (NMES)		activities of daily living and motor function of UL	20/431		Statistically significant but very low quality evidence (heterogeneity, low participant numbers and lack of blinding) for benefits from FES applied within 2 months of stroke on primary outcome of ADL	[88]
		shoulder subluxation, shoulder pain, motor function of UL	10		ES in addition to conventional therapy can be used to prevent or reduce shoulder subluxation early after stroke (<6 months). No evidence of pain reduction or an improvement in the arm motor function.	[89]
		lower limb activity, gait speed, Berg Balance Scale, timed Up and Go, 6-minute walk test, Modified Ashworth Scale, and range of motion	21/ 1481		Moderate benefits (especially when with combination with other interventions or treatment time within either 6 or 12 weeks) on gait speed, balance, spasticity, and range of motion. No significant effect for walking endurance	[90]
		spasticity, range of motion	29/940		ES in combination with other intervention is associated with spasticity reductions and improvements in range of motion	[91]
Transcutaneus Electrical Nerve Stimulation (TENS)		spasticity	10/360		TENS as additional treatment to physical interventions can lead to additional reduction in chronic post-stroke spasticity.	[92]
Repetitive peripheral magnetic stimulation (rPMS)		rPMS for activities of daily living and functional ability	3/121		Inadequate evidence to permit any conclusions about routine use of rPMS for people after stroke	[93]

UL – upper limb, ES –electrical stimulation, FES –functional ES.