Upper extremity training followed by lower extremity training with a brain-computer interface rehabilitation system

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Stroke rehabilitation often focuses on single limb recovery.
• The efficacy of combined upper and lower extremity brain-computer interface (BCI) treatments post-stroke is not well-established.
• Functional electrical stimulation-based BCIs offer a promising avenue for motor rehabilitation.

Purpose of the Study:

• To investigate the effectiveness of sequential upper and lower extremity BCI treatments in stroke patients.
• To assess the impact of combined BCI therapies on motor function, daily living activities, and spasticity.
• To determine if improvements continue after the initial BCI training period.

Main Methods:

• Nineteen stroke patients underwent 25 sessions of upper extremity BCI training followed by 25 sessions of lower extremity BCI training.
• Functional outcomes were measured using the Upper Extremity Fugl-Meyer Assessment (FMA-UE) and the 10-Meter Walk Test (10MWT).
• Clinical scales assessed activities of daily living, spasticity, balance, and mobility.

Main Results:

• Upper extremity BCI treatment led to significant FMA-UE score improvements (4.2 points, p < 0.001), with gains in daily activities and reduced hand/finger spasticity.
• Lower extremity BCI treatment resulted in significant increases in walking speed (0.15 m/s, p = 0.001), improved ankle spasticity, balance, and mobility.
• Overall, patients demonstrated continued functional improvements throughout the combined BCI treatment protocol.

Conclusions:

• Sequential upper and lower extremity BCI treatments are effective in improving motor function and daily activities in stroke survivors.
• The combination of BCI therapies provides a comprehensive approach to stroke rehabilitation, addressing both upper and lower limb impairments.
• BCI treatment efficacy extends beyond initial training periods, suggesting sustained benefits for functional recovery.