Post-stroke Rehabilitation Training with a Motor-Imagery-Based Brain-Computer Interface (BCI)-Controlled Hand...

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Brain-computer interfaces (BCIs) offer a novel approach for motor function restoration after neurological injury.
• Clinical evidence for BCI effectiveness in post-stroke upper limb (UL) rehabilitation remains limited.
• Investigating the efficacy of BCI-driven exoskeleton therapy is crucial for advancing neurorehabilitation.

Purpose of the Study:

• To evaluate the effectiveness of a placebo-controlled, multicenter clinical trial using BCIs for UL motor function recovery in stroke survivors.
• To compare outcomes between a BCI group and a control group receiving exoskeleton therapy without BCI control.
• To assess the impact of BCI training on motor function recovery, measured by standardized clinical assessments.

Main Methods:

• A total of 74 stroke survivors with severe UL paralysis participated in 10 training sessions.
• The BCI group used motor imagery to control an exoskeleton hand opener, receiving contingent sensory feedback.
• The control group received exoskeleton movements independent of their brain activity.

Main Results:

• The BCI group demonstrated significant improvements in ARAT grasp and pinch scores (p < 0.01).
• Higher percentages of patients in the BCI group showed improvements in ARAT (21.8%) and FMMA (36.4%) scores compared to the control group (5.1% ARAT, 15.8% FMMA).
• A correlation was found between BCI classification accuracy and upper extremity functional improvement.

Conclusions:

• Adding BCI control to exoskeleton-assisted physical therapy enhances post-stroke rehabilitation outcomes.
• BCI training is effective in improving motor function for stroke survivors, regardless of stroke duration, severity, or location.
• This study provides strong evidence for the feasibility and effectiveness of BCI-based interventions in neurorehabilitation.