Robotic Technologies for Hand Recovery After Stroke: A Reflection on Research Paths in Honor of Dr. Steven Wolf.

Over the past 35 years, my work has focused on developing and studying robotic technologies to promote hand and arm recovery after stroke. In this Point-of-View, written for a special issue honoring Steven L. Wolf, I reflect on the personal and theoretical factors that shaped my research path, and how they intersect with Steve's pioneering contributions to stroke rehabilitation. I first provide a brief overview of the personal factors that influenced my research journey. Then, I turn to theoretical factors, highlighting conceptual synergies between Constraint-Induced Movement Therapy (CIMT) and robot-assisted therapy, including the principles of dose, task-specific training, shaping, prevention of slacking, participant selection, and the critical role of proprioception. Finally, I discuss 5 implications for future directions in robotic therapy consistent with Dr. Wolf's vision of intensive, patient-centered, and mechanistically grounded therapy: (1) the use of shared principles from CIMT and robot-assisted therapy to guide the design of advanced rehabilitation technologies; (2) precision rehabilitation that prioritizes proprioception; (3) the design of practical, widely adoptable robotic systems; (4) the development of real-time biomarkers and closed-loop training systems that optimize recovery; and (5) the need for deeper collaboration with people with lived experience of disability to address unsolved challenges. Steve's impactful results, driven by his curiosity, rigor, and openness to diverse approaches, have profoundly influenced my career, the ideas I present here, and the broader field of robotic therapy.