In the global burden report, stroke has been described as the epidemic of the 21st century. This statement is based on the high incidence (e.g., 16.000 new patients/year in CH, 1.5 Million/year in Europe, 15 Millions/year in the world) with up to 20% of patients below 55 years. Despite current developments in stroke treatment, full recovery is still limited to 15-20%. This impacts daily life of the individual patients and their relatives and leads to significant cost for them and the society (29 Billion € in Europe). Remaining deficits of upper extremity function, especially hand function, is the main factor determining the re-integration into professional and social life, affecting independence and quality of life. Efforts in improving neuro-rehabilitative therapy remain unsatisfactory leaving still too many patients significantly impaired with a lack of independence and a need of continuous assistance from health care providers. What are the reasons for the still unsatisfactory recovery? Stroke is a heterogeneous disorder, there is insufficient understanding of the processes relevant for recovery, a lack of understanding of courses and degrees of recovery of the individual patients and an insufficient usage of the available rehabilitative treatment strategies (e.g., based on neuro-technologies), especially in the view of personalized, precision medicine. These facts lead to unsatisfactory treatment effects.
