Virtual reality combined with nerve stimulation improves arm and hand function following a stroke

New multimodal rehabilitation platform developed and successfully tested in a study

Medical University of Vienna

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Researchers at the Medical University of Vienna and ETH Zurich have developed a rehabilitation platform for people suffering from the long-term effects of a stroke, which combines virtual reality with targeted sensory nerve stimulation. In a randomised feasibility clinical study with stroke patients, recently published in "Nature Medicine", the new technology contributed to improvements in arm and hand function, as well as in tactile and body awareness. These results open up the prospect of personalised and more accessible rehabilitation that can support patients’ recovery beyond the limits of conventional therapy.

Stroke is one of the leading causes of long-term disability worldwide. Even after intensive early physiotherapy, many stroke survivors continue to live with reduced arm and hand function, impaired sensation and altered body awareness long after the initial event. While conventional rehabilitation can improve motor functions, it often focuses primarily on movement training, instead sensory deficits and body awareness are frequently given insufficient attention. There is therefore a need for more comprehensive rehabilitation strategies.

Personalised training in a virtual environment
To address this need, a research team led by Stanisa Raspopovic (Center for Medical Physics and Biomedical Engineering, MedUni Vienna) has developed "MultiSensy", a rehabilitation platform for patients with arm and hand impairments following a stroke, which combines immersive virtual reality with transcutaneous electrical nerve stimulation. The system turns rehabilitation exercises into interactive virtual tasks designed to train specific arm and hand functions, including reaching, grasping, pinching, and forearm rotation. 

At the same time, electrodes attached to their skin stimulate the nerves in real time, allowing participants to feel virtual objects as if they were physically touching them. Inspired by occupational therapy principles, the games can be adapted to each participant’s impairment level, allowing training to be both targeted and engaging. "Our aim was to go beyond mere movement training," says study leader Stanisa Raspopovic. "After a stroke, patients often have difficulty not only moving the affected limb, but also feeling it and perceiving it correctly. MultiSensy was developed to reconnect movement, sensation and body awareness during rehabilitation." 

The system was tested on 34 patients who had suffered a stroke more than three months before the study. Some participants trained using MultiSensy: they wore VR goggles and performed arm and hand exercises in a digital training environment designed to simulate everyday tasks. The control group received conventional rehabilitation, including physiotherapy and occupational therapy. Both groups completed a three-week rehabilitation protocol consisting of twelve training sessions. The clinical examinations were supported by a team from the Faculty of Medicine in Belgrade.

Improvements in function and body perception 
The study showed greater improvements in arm and hand recovery in participants treated with MultiSensy than in those receiving conventional rehabilitation. In the Fugl-Meyer Assessment for the upper limb, a standard measure of motor impairment after stroke, the MultiSensy group showed nearly twice the improvement observed in the control group. Similar benefits were also seen in the Action Research Arm Test, which evaluates how well patients can use their arm and hand in everyday functional tasks. But motor disability is just a part of the problem. "After a stroke, some patients struggle to feel touch in their affected hand and may even perceive the arm as distorted in size, shape, or position. Participants treated with the new system showed improvements in their sense of touch and in perception of their affected arm," adds lead author Valerio Aurucci (ETH Zurich). Furthermore, the platform collects movement data during training, providing objective indicators of rehabilitation progress. This allows patients’ performance and recovery to be monitored over time, helping clinicians to assess progress more precisely and adapt therapy for each individual.

"The results provide early clinical evidence that immersive virtual reality combined with sensory nerve stimulation can support recovery after stroke, even after months from the event", says Stanisa Raspopovic. "The technology is still at the research stage, and larger clinical trials are needed to confirm its benefits. However, the study opens a promising perspective for future personalised and potentially home-based stroke rehabilitation."

 

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Journal

Nature Medicine

DOI

10.1038/s41591-026-04486-4 

Article Title

Immersive virtual reality with synchronous neurostimulation for upper-limb recovery after stroke: a randomized feasibility trial

Article Publication Date

26-Jun-2026

 

Do animal behavior experiments give us a distorted view of cooperation?

More realistic experiments reveal a different side of animal social behaviour

Utrecht University, Faculty of Science

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When only one cooperation device was available, almost all cooperation took place between two young males (left). When three or five devices were offered, cooperation became much more evenly distributed throughout the group.

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Credit: Utrecht University

When biologists study cooperation in animals, they usually offer just a single task at a time. But what happens when animals can choose between several opportunities to work together? Biologists at Utrecht University discovered that this can make a remarkable difference. Their findings raise a broader question: do many behavioural experiments offer only a limited view of how animals actually behave in the wild?

Behavioural scientists often study cooperation using a simple experiment. Two animals must pull ropes simultaneously to obtain a reward. Usually, only one such apparatus is placed in front of the enclosure.

This resembles situations in nature in which a group of animals cooperates to capture a single prey item. But for many primates, such situations are relatively rare. Much more often, monkeys spend their time foraging for food in trees and shrubs, where several food sources are available at the same time.

Changing social dynamics
“When monkeys gather to obtain food, they usually have more than one opportunity in nature,” says primatologist Liesbeth Sterck, who led the study. “A fruit tree does not contain just one place where fruit is available, but many. That allows animals to avoid one another, observe one another, or actively seek each other out. But when there’s only a single opportunity to obtain food, the social dynamics are very different.”

According to Sterck, this means researchers should be cautious when drawing conclusions from experiments that offer only one place to cooperate. Such experiments mainly show how animals behave when there is only a single opportunity available. Once several opportunities are introduced, partner preferences can change.

From one dominant duo to an entire group
Sterck’s team discovered this while studying a group of long-tailed macaques. Instead of offering the monkeys just one cooperation device, they sometimes provided three or even five.

When only one device was available, it was almost entirely occupied by two adolescent males. They accounted for the vast majority of cooperative interactions in the group to obtain a food reward.

But when three or five devices became available, the social dynamics changed dramatically. Cooperation became much more evenly distributed throughout the group. The two males remained active, but they no longer dominated the task. They also began cooperating with other group members.

“When there is only one place to cooperate, you create a very specific situation,” says Sterck. “That does not mean previous studies using this setup were wrong. But it does mean that our interpretation of the animals’ behaviour may depend strongly on how many opportunities they are given.”

The peppernut principle
Sterck uses a typically Dutch example to explain the effect: the Sinterklaas celebration, during which small spiced biscuits known as “pepernoten” are thrown into crowds of children.

“During Sinterklaas celebrations, these treats are scattered over a large area, and not offered to the children in one single spot,” she says. “That reduces competition and prevents arguments among children. We see something similar in our study. When there are several places where rewards can be obtained, the behaviour of the group changes.”

Hunting in the wild
Biologist Jeroen Zewald, who conducted the study as a biology student at Utrecht University, compares the findings to hunting in the wild.

“Imagine hunting deer together when there is only a single animal available,” he says. “You want a partner who is good at hunting but who will not keep the entire reward afterwards. If there are prey animals everywhere, it matters much less whom you choose to cooperate with. The monkeys showed exactly this difference.”

The findings underline how strongly social behaviour depends on the surrounding environment. Animals themselves do not solely determine whom they cooperate with; the opportunities available to them matter as well.

Implications beyond animal cooperation
The researchers believe the findings may have consequences far beyond studies of cooperation.

Many other behavioural experiments, including studies of social learning and animal culture, also rely on a single location or a single apparatus. This may limit the opportunities animals have to observe one another, learn from one another, or participate in the task.

If we want to understand how animals cooperate in the wild, we may also need to pay more attention to how many opportunities they have to do so, the researchers conclude.

The study was published today in the journal Animal Behaviour.

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Journal

Animal Behaviour

DOI

10.1016/j.anbehav.2026.123632 

Method of Research

Observational study

Subject of Research

Animals

Article Title

Monopolization and cooperation: number of locations affects cooperation and partner preference in long-tailed macaques

Article Publication Date

26-Jun-2026

Long-tailed macaques taking part in the cooperation experiment. The monkeys could obtain a food reward only by pulling the ropes together at the same time. (Photo: L.M. van den Berg)

Credit

Utrecht University / L.M. van den Berg

 

Shifting tectonic plates gave Alaska’s Aleutian Islands a later-life lift

Brown University

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New research by Brown University geologists confirms that the Aleutian Islands, the archipelago stretching from Alaska to Russia’s Kamchatka Peninsula, experienced a massive geological uplift between 5 million and 7 million years ago. 

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Credit: Anahi Carrera

PROVIDENCE, R.I. [Brown University] — New research by Brown University geologists confirms that the Aleutian Islands, the archipelago stretching from Alaska to Russia’s Kamchatka Peninsula, experienced a massive geological uplift between 5 million and 7 million years ago. 

The researchers conclude that the uplift — a rising of the Earth’s crust that pushed the islands upwards and transformed their topography— was driven by an ancient rotation of the Pacific tectonic plate, which subducts beneath the North American plate near the Alaska Peninsula and the North Pacific.

“Our study presents the first evidence that the Aleutian Islands experienced this dramatic, chain-wide episode of uplift and erosion around 5 to 7 million years ago,” said Anahi Carrera, the study’s lead author who worked on the project as a doctoral student at Brown. “This was a time period when there was a major shift in the motion of the Pacific Plate, which we think is what caused these islands to be deformed and uplifted at the same time across this large distance.”

The federally funded research, which Carrera co-authored with Emily Cooperdock, an assistant professor of Earth, environmental and planetary sciences and a faculty affiliate of the Institute at Brown for Environment and Society (IBES), is published in the journal Geology. 

The Aleutian Islands form the northern boundary of the Ring of Fire, an arc of frequent volcanic and seismic activity that surrounds the Pacific Ocean. The islands themselves were formed by ancient volcanic activity beginning roughly 55 million years ago when the Pacific tectonic plate began subducting under the North American plate. 

When one tectonic plate subducts beneath another, water and other volatiles trapped in the subducting plate cause melting in the mantle just below the crust. That leads to intense volcanic and earthquake activity along the plate boundaries. That much about subduction zones is well understood, Cooperdock said, but there are other dynamics at play that remain mysterious. 

“Island arcs like the Aleutians are really dynamic places and some of the least understood places on our planet,” she said. “Understanding what drives them in terms of things like uplift and erosion has been a really hard puzzle to crack.”

The first hints that an uplift event had occurred across the Aleutians came in the 1970s when oceanographers took sediment cores from the ocean floor surrounding the islands. The cores contained an anomalous layer of land-derived clay minerals and other sediment deposited during a relatively short period several million years ago. One scenario to explain that sediment is that the islands were suddenly deformed and lifted upward, where stronger winds and heavier rains could carry sediment into the ocean. 

But outside the sediment layer, there was no direct evidence for an uplift event, or the timing of this event, in the Aleutians — that is, until this research. 

For the study, Cooperdock and Carrera, who is now a postdoctoral researcher at Pacific Northwest National Laboratory, used a technique called apatite thermochronometry to analyze rock samples taken from across the Aleutian archipelago, a span of nearly 1,000 miles. The technique measures the amount of helium gas found within crystals of the mineral apatite.

Apatite contains trace amounts of the radioactive elements uranium and thorium. The decay of those elements produces helium, which escapes the apatite when the crystals are buried deep underground at high temperatures. But when the rocks move from deep underground to near the surface, they cool dramatically, and the helium can no longer escape. By measuring how much helium is trapped in the apatite, and comparing it to how much uranium and thorium remain, the researchers can estimate when the rock cooled, which reveals roughly when it made its way to the surface. 

The researchers found that 77% of the rocks they analyzed had cooled down at roughly the same time — a span between around 5 million to 7 million years ago. The cooling ages were consistent regardless of the formation age of the rocks and despite having come from far-separated islands across the arc. The consistent cooling age suggests the rocks came to the surface around the same time, providing the first direct evidence for a massive uplift event that spanned the entire island arc.  

The timing of the uplift coincides with a previously known event during which the Pacific plate rotated, causing widespread deformation and uplift along the Ring of Fire. It’s now clear, the researchers say, that this plate rotation, driven by the slow churning of Earth’s mantle, caused this dramatic uplift of the Aleutians. 

“It’s really exciting to be able to show that these processes deep within the Earth — many kilometers in depth — are actually driving what we see on the surface,” Carrera said. “It’s great to have this amazing dataset that’s able to demonstrate that link.”

The research was supported by the U.S. National Science Foundation (EAR-1949148).

 

New research by Brown University geologists confirms that the Aleutian Islands, the archipelago stretching from Alaska to Russia’s Kamchatka Peninsula, experienced a massive geological uplift between 5 million and 7 million years ago. 

Credit

Anahi Carrera

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Journal

Geology

DOI

10.1130/G54594.1 

Article Title

Synchronous arc exhumation of the central and western Aleutian Islands at 7–5 Ma, Alaska, USA

Article Publication Date

17-Jun-2026

 

Global burden of viral skin diseases rises 36% since 1990: Children and elderly bear the brunt

Higher Education Press

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Credit: HIGHER EDUCATION PRESS

Viral skin diseases are among the most common infectious conditions globally, causing significant disability and straining healthcare systems despite often being perceived as mild.

 

Using data from the 2021 Global Burden of Disease Study, researchers analyzed trends across 7.97 billion individuals. While age-standardized rates remained stable, absolute cases rose sharply: annual incidence increased 32.27% to 84.7 million, prevalence grew 36.29% to 136.8 million, and disability-adjusted life years (DALYs) climbed 35.81% to 4.2 million, driven primarily by population growth and aging.

 

Stark disparities emerged: children under 15 bore the highest burden, with incidence rising 44.2% in those under 5; notably, children aged 5–9 had the highest incidence and prevalence rates globally in both 1990 and 2021. Adults aged 50–65 and 85–95 also saw significant increases, and males consistently had higher rates than females. Geographically, high-income regions (led by Germany) had the highest current burden, but the fastest growth occurred in low- and middle-income countries, particularly Central Latin America and Western Sub-Saharan Africa. Projections show global cases will continue rising until around 2030.

 

The findings underscore the need for equitable policies: while high-income countries have made progress via vaccination and better healthcare, low-resource regions lag behind. Targeted interventions for vulnerable populations are critical to reducing the global burden.

The work titled “Global, Regional, and National Burdens of Viral Skin Diseases from 1990 to 2021: A Cross-Sectional and Time-Series Analyses” was published in Skin on May 14, 2026.

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DOI

10.2738/SKIN.2026.0007 

Method of Research

Experimental study

Subject of Research

Not applicable

Article Title

Global, Regional, and National Burdens of Viral Skin Diseases from 1990 to 2021: A Cross-Sectional and Time-Series Analyses

 

Participatory theatre helps young people become active citizens

Estonian Research Council

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Nikolai Kunitsõn

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Credit: Nikolai Kunitsõn and Tallinn University

In Estonian schools, social studies classes provide a thorough education on what democracy is and what it means to be a citizen. However, knowledge alone is not enough to foster active citizenship or to reduce the differences in civic skills between Estonian- and Russian-speaking young people. A doctoral thesis by Nikolai Kunitsõn, a political scientist at Tallinn University, shows that participatory theatre can bridge this gap.

Democracies around the world are currently under pressure from both external and internal sources. To thrive, open societies need active citizens who possess the skills required to participate in democracy. Nikolai Kunitsõn examined how the development of such citizens could be better supported. This is particularly important for young people attending Russian-language schools, as it helps reduce the differences in democratic knowledge and civic skills between Estonian- and Russian-speaking young people.

“Social studies classes in Estonian schools are overloaded with factual knowledge, while the teaching of skills takes a back seat," explains the political scientist. "Teachers have a great deal of freedom, but also a great deal of responsibility, which exacerbates inequality in Russian-language schools.”

When it comes to shaping young people into active citizens, acquiring theoretical knowledge in school classes is not enough. The skills that an active citizen needs on a daily basis – debating, resolving differences of opinion and taking a stand – must also to be practised. As a solution, Nikolai Kunitsõn proposes a participatory theatre method called forum theatre, where young people can learn the necessary new skills in a playful way.

 

Participatory theatre brings real-life problems to the stage

In forum theatre, the participants act out a real-life problem. The same story is then repeated, but this time any member of the audience can shout “stop”, come up on stage, take the place of a character and try to resolve the situation differently. Essentially, this means that anyone can change the course of the performance and propose their own solution. “Forum theatre allows young people to look at a situation from the sidelines and then try to see how things could be done differently,” explains Kunitsõn.

Over the course of nine months, Kunitsõn conducted workshops and performances with Russian-speakers between the ages of 14 to 21, during which the young people created stories based on their own experiences and presented them to their peers. The changes were noticeable: the young people began to see situations from multiple perspectives, notice others’ feelings, solve problems more creatively and became more self-confident in the process. This was true even for topics involving ingrained thought patterns.

 

A solution to reduce division

Until now, there has been a theoretical understanding that it is possible to challenge entrenched beliefs in schools, but there has been no clear and precise mechanism for doing so. Kunitsõn demonstrates that participatory theatre helps change people’s deeply ingrained patterns of thought and behaviour – things that are taken for granted and seem “normal”. This makes it possible to reduce the differences in democratic knowledge and civic skills between Estonian- and Russian-speaking young people. This is an important finding, as the development of civic skills affects the cohesion of Estonian society as a whole. “Simply switching schools to Estonian-language teaching will neither foster active citizens nor bridge the divide between young people," says Kunitsõn. "Young people need to have real opportunities to practice civic skills, and participatory theatre is a surprisingly good way to do that.”

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DOI

10.60518/etera/149