Technology of Activation of Regenerative Rehabilitation: Mechanisms and Neuroendocrine Modulation - A Narrative Review

Abstract

Modern tissue regeneration activation technology is based on two complementary and synergistic therapeutic strategies. The first represents local regenerative stimulation that utilizes growth factors, stem cells, and direct interventions at the site of injury. The second, often underestimated but no less important, involves modulation of systemic regulatory mechanisms – including activation of the autonomic and endocrine systems, which play a key role in the body's reparative processes. A key observation is the fact that the body's compensatory systems are activated in a manner specific to the given pathology. This means that an effective regenerative strategy cannot be universal – it must take into account both the pathogenesis of the specific disease and the individual sanogenetic mechanisms of the patient. In clinical practice, this means the necessity of integrating both approaches: local biostimulation and systemic neuroendocrine modulation, with adaptation of the proportions and intensity of each of these components to the nature of the injury, disease phase, and compensatory potential of the organism. Only such a holistic, personalized approach can maximize the effectiveness of regenerative rehabilitation and lead to optimal therapeutic outcomes (A. Gozhenko). (Gozhenko et al., 2019; Gozhenko et al., 2021).

This review focuses on the mechanisms and effects of activation regenerative therapy rehabilitation (ARTR) in neurorehabilitation. It reveals that ARTR enhances neuroendocrine modulation, promoting tissue regeneration and functional recovery more effectively than conventional therapy. Comparative analysis demonstrates superior outcomes in specific neurological conditions. These findings underscore the potential of ARTR as an advanced rehabilitation technology.

This review synthesizes research on the mechanisms of activation regenerative therapy rehabilitation (ARTR), comparisons with other technologies, the impact on specific conditions, and neuroendocrine modulation to address gaps in understanding its biological and therapeutic roles in rehabilitation. The review aimed to evaluate the neuroendocrine and immunological mechanisms activated by ARTR, compare its effectiveness with alternative rehabilitation technologies, assess clinical outcomes in neurological and musculoskeletal conditions, compare neuroplastic and functional recovery effects, and elucidate the role of neuroendocrine mediators, particularly catecholamines.

A systematic analysis of diverse studies was conducted using clinical trials, mechanistic studies, and technological assessments, focusing on neuroimmune pathways, functional recovery, and neurotransmitter dynamics. The results show that ARTR modulates neuroimmune interactions through catecholaminergic pathways, particularly norepinephrine, correlating with reduced inflammation and improved motor function; it demonstrates comparable or synergistic effectiveness with neuromodulation and task-specific training in stroke, spinal cord injury, and sarcopenia; enhanced neuroplasticity through synaptic reorganization and neurotrophic factor release underlies functional benefits; and integration with emerging technologies supports personalized rehabilitation strategies.

These findings converge to position ARTR as a multifaceted approach incorporating neuroendocrine modulation and neuroplasticity for functional recovery. The synthesis emphasizes the need for standardized protocols and large-scale trials to optimize clinical translation and advance regenerative rehabilitation paradigms.