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Updated: Aug 8, 2026

Motor Imagery Brain-Computer Interface in Rehabilitation of Upper Limb Motor Dysfunction After Stroke
Published on: September 1, 2023
Effects of brain-computer interface-based training on post-stroke lower limb rehabilitation: A systematic review and
Xingyu Liu1, Peng Huang1, Linjie Wu1
1School of Sports Medicine and Rehabilitation, Beijing Sport University, No. 48 Xinxi Road, Haidian District, Beijing, 100080, China.
Background:
Lower-limb motor dysfunction after stroke severely compromises mobility and quality of life. Brain-computer interface (BCI) technology, which employs a "central-peripheral-central" closed-loop to promote neuroplasticity, offers a promising rehabilitation approach. However, its optimal dosing parameters remain unclear.
Objective:
This study aimed to evaluate the efficacy of BCI-based training on lower-limb motor function, balance, walking capacity, and activities of daily living (ADL) after stroke, and to explore the impact of total training dose, session duration, and stroke phase.
Methods:
We systematically searched major databases for randomized controlled trials (RCTs) published up to April 2026. All included studies were RCTs. Methodological quality was assessed using the PEDro scale. A meta-analysis was conducted using RevMan 5.4 to calculate mean differences (MD) and 95% confidence intervals (CI).
Results:
Ten RCTs involving 366 participants were included. BCI training significantly improved lower-limb motor function (Fugl-Meyer Assessment for Lower Extremity: MD = 2.38, 95% CI 1.72 to 3.04, P < 0.00001). Although this mean difference is below the anchor-based Minimal Clinically Important Difference (MCID) of 6 points reported for chronic stroke populations, it represents a statistically robust and consistent improvement across RCTs, suggesting potential clinical relevance, particularly in subacute patients or specific intervention subgroups.
Conclusions:
BCI-based training effectively improves lower-limb motor recovery after stroke. Subgroup analyses suggested that a moderate total dose (401-800 minutes) combined with 20-40-minute sessions may represent a potentially optimal regimen, although these findings are based on limited RCTs and require confirmation in larger studies.

