To investigate the efficacy of integrated occupational therapy (OT) based on the ICF framework on the rehabilitation of patients with upper limb dysfunction after stroke, and to verify the clinical value of multimodal intervention strategies in improving neuromuscular control, promoting functional compensation and reducing complications.

Subjects: A total of 120 patients with post-stroke upper limb dysfunction admitted to Tai'an Central Hospital from January 2024 to March 2025 were included, and they were randomly divided into control group (conventional OT) and intervention group (integrated OT), with 60 cases in each group.

Intervention Options:

Control group: conventional occupational therapy (scapula loosening training, range of motion training, grasping training);

Intervention group:

ICF Individualized Approach: Goals based on physical function, activity participation, and environmental factors (e.g., ADL tasks such as dressing and eating);

Multi-modal task training: combined with virtual reality (VR) to simulate ADL scenarios (such as virtual kitchen operations) to strengthen hand-eye coordination and fine motor skills;

Nerve activation technique: Functional electrical stimulation (FES) is used to enhance muscle contraction and innervation of the affected limb.

Evaluation indicators: Before treatment, after 8 weeks of treatment:

Main indicators: Fugl-Meyer Upper Limb Function Score (FMA-UE), Modified Barthel Index (MBI);

Secondary indicators: Surface electromyography (sEMG) was used to detect the root mean square value (RMS) and the incidence of complications (muscle atrophy/joint contracture) of brachioradialis muscle on the affected side.

Functional improvement: Compared with the control group, the FMA-UE score in the intervention group increased by 30.2% (52.1±6.3 vs. 40.0±5.7, P<0.01), and the MBI score increased by 36.8% (67.5±6.8 vs. 49.3±6.2, P<0.01).

Nerve activation efficiency: The sEMG-RMS value of the intervention group was significantly higher than that of the control group (brachioradialis muscle: 41.5±4.6 μV vs. 30.1±3.8 μV, P<0.05), indicating enhanced innervation.

Complication control: The incidence of muscle atrophy and joint contracture in the intervention group was reduced by 22.4% (7.1% vs. 29.5%, P<0.05).

Treatment adherence: the dropout rate was only 4.2% in the integrated OT group (17.5% in the control group).

Clinical effectiveness: Occupational therapy integrating ICF framework and multimodal task training, through VR scene simulation and FES neural activation, significantly improved the efficiency of upper limb motor function reconstruction in stroke patients, and accelerated the recovery of ADL ability.

Mechanism innovation: The role of the "task-oriented training-neuroplasticity" linkage mechanism in OT was verified, and functional electrical stimulation could enhance the efficiency of neuromuscular signaling.

Transformation significance: This model relies on the smart rehabilitation technology (such as VR and FES) of Tai'an Central Hospital, which can be extended to primary medical care and promote the standardization process of neurological rehabilitation.