From virtual practice to real-world function the transfer problem in digital neurorehabilitation
9 affiliations
- 1Faculty of Sports Sciences, Firat University
- 2Department of Sports Management, Faculty of Sports Sciences, Atatürk University
- 3Department of Sports Injuries and Corrective Exercises, Faculty of Sports Sciences, Shahid Bahonar University of Kerman
- 4HERC – Health, Exercise & Research Center
- 5Department of Coaching Education, Faculty of Sports Sciences, Eurasia University
- 6Department of Sports Management, Faculty of Sports Sciences, Mardin Artuklu University
- 7Department of Sports Management, Faculty of Sport Sciences, Istanbul Topkapi University
- 8Faculty of Sport Sciences, Hitit University
- 9Department of Physical Education, Technical and Vocational University (TVU)
Abstract
Digital technologies have expanded opportunities for neurorehabilitation by enabling intensive, interactive, and adaptable motor practice. However, improvements achieved within virtual environments, rehabilitation games, or technology-based assessments do not necessarily translate into meaningful changes in everyday function. This Mini Review examines the transfer problem in digital neurorehabilitation and discusses key factors that may limit the generalization of training-related gains to real-world performance. We synthesize evidence regarding task specificity, sensory and perception-action differences between digital and physical environments, cognitive and contextual demands, practice variability, and patient-specific constraints that influence transfer. Based on these mechanisms, we propose a transfer-oriented framework consisting of five interconnected stages: skill acquisition, adaptive variability, cognitive-motor integration, contextualized real-world practice, and ecological evaluation. This framework emphasizes that transfer should be deliberately targeted rather than assumed as a consequence of successful digital training. We further discuss how virtual reality, augmented reality, wearable sensing, and hybrid rehabilitation models may support different stages of this process when integrated within adaptive and personalized approaches. Future digital rehabilitation research should move beyond evaluating performance within trained tasks and incorporate measures of functional and ecological transfer, including real-world mobility, activity, and participation. A shift from technology-centered rehabilitation toward transfer-oriented design may enhance the clinical impact of digital interventions and support meaningful improvements in daily life.
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BibTeX
@article{karadag2026from,
title = {{From virtual practice to real-world function the transfer problem in digital neurorehabilitation}},
author = {Mustafa Karadag and Mehmet Bahadır Ercis and Mohammad Alimoradi and Dilek Karadağ and Ceyhun Kabal and Izzet Karakulak and Mehmet Bayansalduz and Levent Ceylan and Mojtaba Iranmanesh and Mohammad Alghosi},
journal = {Frontiers in Neurology},
year = {2026},
month = oct,
doi = {10.3389/fneur.2026.1976066},
url = {https://www.frontiersin.org/articles/10.3389/fneur.2026.1976066/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - From virtual practice to real-world function the transfer problem in digital neurorehabilitation
AU - Mustafa Karadag
AU - Mehmet Bahadır Ercis
AU - Mohammad Alimoradi
AU - Dilek Karadağ
AU - Ceyhun Kabal
AU - Izzet Karakulak
AU - Mehmet Bayansalduz
AU - Levent Ceylan
AU - Mojtaba Iranmanesh
AU - Mohammad Alghosi
PY - 2026
DA - 2026/10/23
JO - Frontiers in Neurology
DO - 10.3389/fneur.2026.1976066
UR - https://www.frontiersin.org/articles/10.3389/fneur.2026.1976066/full
AB - Digital technologies have expanded opportunities for neurorehabilitation by enabling intensive, interactive, and adaptable motor practice. However, improvements achieved within virtual environments, rehabilitation games, or technology-based assessments do not necessarily translate into meaningful changes in everyday function. This Mini Review examines the transfer problem in digital neurorehabilitation and discusses key factors that may limit the generalization of training-related gains to real-world performance. We synthesize evidence regarding task specificity, sensory and perception-action differences between digital and physical environments, cognitive and contextual demands, practice variability, and patient-specific constraints that influence transfer. Based on these mechanisms, we propose a transfer-oriented framework consisting of five interconnected stages: skill acquisition, adaptive variability, cognitive-motor integration, contextualized real-world practice, and ecological evaluation. This framework emphasizes that transfer should be deliberately targeted rather than assumed as a consequence of successful digital training. We further discuss how virtual reality, augmented reality, wearable sensing, and hybrid rehabilitation models may support different stages of this process when integrated within adaptive and personalized approaches. Future digital rehabilitation research should move beyond evaluating performance within trained tasks and incorporate measures of functional and ecological transfer, including real-world mobility, activity, and participation. A shift from technology-centered rehabilitation toward transfer-oriented design may enhance the clinical impact of digital interventions and support meaningful improvements in daily life.
SN - 1664-2295
ER -