Brain-computer interface robotics for hand rehabilitation after stroke: a systematic review

Area of Science:

• Neuroscience
• Robotics
• Rehabilitation Medicine

Background:

• Hand rehabilitation is crucial for stroke survivors to regain daily living activities.
• Electroencephalography-based brain-computer interfaces (BCI) are emerging as a tool to enhance this recovery process.
• This study systematically reviews BCI-robot systems for fine motor skill rehabilitation in hand movement.

Purpose of the Study:

• To systematically examine the literature on BCI-robot systems for hand rehabilitation.
• To profile these systems technically and clinically.
• To identify the current state of development and clinical application of these technologies.

Main Methods:

• A systematic literature search was conducted from January 2010 to October 2019 across multiple databases (Ovid MEDLINE, Embase, PEDro, PsycINFO, IEEE Xplore, Cochrane Library).
• Inclusion criteria focused on BCI-hand robotic systems for rehabilitation, tested on healthy individuals or stroke patients.
• Data extracted included study design, participant characteristics, system technical specifications, and clinical outcomes.

Main Results:

• 30 studies were included; 11 tested BCI-hand robots on stroke patients (chronic and subacute).
• Three BCI-hand robot interventions showed statistically significant improvements in motor assessment scores compared to controls.
• Most systems utilized motor imagery to control grasping/pinching movements, integrating kinaesthetic and visual feedback.

Conclusions:

• 19 out of 30 studies reported systems at prototype or pre-clinical stages.
• Significant heterogeneity exists in reporting methods and outcomes.
• Standardized protocols are needed for assessing technical and clinical outcomes to build evidence for efficacy and efficiency.