
THERAPY Magazin
Neurorehabilitation at the interface between theory and practice
Discover how even inconclusive neurorehabilitation studies offer valuable insights. Learn why targeted, life-oriented therapies and digital tools are key to personalised, effective stroke recovery.

Jakob Tiebel
Business Owner, N+ Digital Health Agency
Over the past two decades, neurorehabilitative research has conducted numerous randomised, multicentre studies on specific therapy methods. While some studies showed significant successes, particularly in regaining walking ability after a stroke, others could not demonstrate a clear superiority of new interventions compared to standard therapies. Previous and current issues of THERAPY also reported on this. The following essay summarises the author’s fundamental thoughts on this subject.
The “negative” finding – no reason for nihilism but a catalyst for precision
That a therapeutic intervention shows no significant effect in a large, ethically well-founded study is often hastily judged a “failure”. Such supposedly “negative” findings can make a valuable contribution to the acquisition of knowledge: they illustrate that a clear objective and an appropriate classification of underlying principles of interventions are key. If, for example, a specific ability such as walking speed, endurance or everyday competence is to be improved, training methods and content must have this specific focus and be carried out with sufficient intensity. Negative study results do not signal a failure of neurorehabilitation, but rather indicate potential for optimisation. They call for a more precise definition of dose-response relationships, target criteria and stronger integration of interventions into everyday care. Thus, seemingly sobering findings also contribute to the further development of more effective therapeutic approaches.
That a therapeutic intervention shows no significant effect in a large, ethically well-founded study is often hastily judged a “failure”. Such supposedly “negative” findings can make a valuable contribution to the acquisition of knowledge: they illustrate that a clear objective and an appropriate classification of underlying principles of interventions are key. If, for example, a specific ability such as walking speed, endurance or everyday competence is to be improved, training methods and content must have this specific focus and be carried out with sufficient intensity. Negative study results do not signal a failure of neurorehabilitation, but rather indicate potential for optimisation. They call for a more precise definition of dose-response relationships, target criteria and stronger integration of interventions into everyday care. Thus, seemingly sobering findings also contribute to the further development of more effective therapeutic approaches.
From lab to life
The clinic remains essential for diagnosis, therapy and monitoring, but limited time and staff resources make flexible, individually tailored neurorehabilitation difficult. The shift of therapeutic measures to the domestic and community-based setting is therefore becoming increasingly important. Patients can practise movement sequences in familiar surroundings – while shopping, walking or climbing the stairs at home. This enables sustainable training that can be better adapted to daily life, personal needs, rhythms and preferences.
Another advantage is that it reinforces personal responsibility and self-efficacy. If patients can integrate and adapt their training to their daily lives, this often motivates them to continue their rehabilitation. Digital technologies and therapeutic aids help them to share data with their healthcare teams, document progress and receive targeted feedback – all without face-to-face appointments.
The combination of inpatient therapy and lifeoriented rehabilitation creates a flexible, forward-looking model that better combines intensity, continuity and individualisation in neurorehabilitation. Developing tailored concepts that optimise the benefits of both approaches is critical.
The clinic remains essential for diagnosis, therapy and monitoring, but limited time and staff resources make flexible, individually tailored neurorehabilitation difficult. The shift of therapeutic measures to the domestic and community-based setting is therefore becoming increasingly important. Patients can practise movement sequences in familiar surroundings – while shopping, walking or climbing the stairs at home. This enables sustainable training that can be better adapted to daily life, personal needs, rhythms and preferences.
Another advantage is that it reinforces personal responsibility and self-efficacy. If patients can integrate and adapt their training to their daily lives, this often motivates them to continue their rehabilitation. Digital technologies and therapeutic aids help them to share data with their healthcare teams, document progress and receive targeted feedback – all without face-to-face appointments.
The combination of inpatient therapy and lifeoriented rehabilitation creates a flexible, forward-looking model that better combines intensity, continuity and individualisation in neurorehabilitation. Developing tailored concepts that optimise the benefits of both approaches is critical.
Conclusion: no reason for resignation
Large-scale studies with no clinically relevant difference do not show the limitations of rehabilitation research, but emphasise the importance of dose-response relationships, target specification and environmental factors – in theory and practice. Technological innovations and combination therapies offer opportunities to increase effectiveness, while individual support sustainably improves everyday walking ability and quality of life.
In this way, a supposedly “negative” picture of the current body of evidence once again proves to be an impetus for new perspectives and innovative approaches. The challenge is to specify interventions with a view to different target groups and contexts, to make sensible use of larger data pools and to promote close integration of research and everyday clinical practice. This is the key to advancing rehabilitation research – and to sustainably strengthening the participation and autonomy of people after a stroke.
Large-scale studies with no clinically relevant difference do not show the limitations of rehabilitation research, but emphasise the importance of dose-response relationships, target specification and environmental factors – in theory and practice. Technological innovations and combination therapies offer opportunities to increase effectiveness, while individual support sustainably improves everyday walking ability and quality of life.
In this way, a supposedly “negative” picture of the current body of evidence once again proves to be an impetus for new perspectives and innovative approaches. The challenge is to specify interventions with a view to different target groups and contexts, to make sensible use of larger data pools and to promote close integration of research and everyday clinical practice. This is the key to advancing rehabilitation research – and to sustainably strengthening the participation and autonomy of people after a stroke.
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THERAPY 2025-I
THERAPY Magazine

Jakob Tiebel
Business Owner, N+ Digital Health Agency
Jakob Tiebel studied applied psychology with a focus on health economics. He has clinical expertise from his previous therapeutic work in neurorehabilitation. He conducts research and publishes on the theory-practice transfer in neurorehabilitation and is the owner of Native.Health, an agency for digital health marketing.
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