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Updated: Mar 1, 2026
Brain-Computer Interface-controlled Upper Limb Robotic System for Enhancing Daily Activities in Stroke Patients
Published on: April 18, 2025
Contralesional Brain-Computer Interface Control of a Powered Exoskeleton for Motor Recovery in Chronic Stroke
David T Bundy1, Lauren Souders1, Kelly Baranyai1
1From the Department of Rehabilitation Medicine, University of Kansas Medical Center, Kansas City (D.T.B.); Departments of Biomedical Engineering (D.T.B., R.C., D.W.M., E.C.L.), Neurology (L.S., K.B., L.L., T.H.), Neurological Surgery (E.C.L.), Mechanical Engineering and Material Sciences (E.C.L.), and Neuroscience (E.C.L.), Washington University, St. Louis, MO; and National Center for Adaptive Neurotechnologies, Wadsworth Center, NYS Department of Health, Albany, NY (G.S.).
Background And Purpose:
There are few effective therapies to achieve functional recovery from motor-related disabilities affecting the upper limb after stroke. This feasibility study tested whether a powered exoskeleton driven by a brain-computer interface (BCI), using neural activity from the unaffected cortical hemisphere, could affect motor recovery in chronic hemiparetic stroke survivors. This novel system was designed and configured for a home-based setting to test the feasibility of BCI-driven neurorehabilitation in outpatient environments.
Methods:
Ten chronic hemiparetic stroke survivors with moderate-to-severe upper-limb motor impairment (mean Action Research Arm Test=13.4) used a powered exoskeleton that opened and closed the affected hand using spectral power from electroencephalographic signals from the unaffected hemisphere associated with imagined hand movements of the paretic limb. Patients used the system at home for 12 weeks. Motor function was evaluated before, during, and after the treatment.
Results:
Across patients, our BCI-driven approach resulted in a statistically significant average increase of 6.2 points in the Action Research Arm Test. This behavioral improvement significantly correlated with improvements in BCI control. Secondary outcomes of grasp strength, Motricity Index, and the Canadian Occupational Performance Measure also significantly improved.
Conclusions:
The findings demonstrate the therapeutic potential of a BCI-driven neurorehabilitation approach using the unaffected hemisphere in this uncontrolled sample of chronic stroke survivors. They also demonstrate that BCI-driven neurorehabilitation can be effectively delivered in the home environment, thus increasing the probability of future clinical translation.
Clinical Trial Registration:
URL: http://www.clinicaltrials.gov. Unique identifier: NCT02552368.
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