ABSTRACT
Introduction:
Brain-computer interfaces (BCIs) based on functional
electrical stimulation have been used for
upper extremity motor
rehabilitation after
stroke. However, little is known about their
efficacy for multiple BCI
treatments. In this study, 19
stroke patients participated in 25
upper extremity followed by 25
lower extremity BCI
training sessions.
Methods:
Patients' functional
state was assessed using two sets of clinical
scales for the two BCI
treatments. The
Upper Extremity Fugl-Meyer Assessment (FMA-UE) and the 10-Meter
Walk Test (10MWT) were the primary
outcome measures for the upper and
lower extremity BCI
treatments, respectively.
Results:
Patients' motor function as assessed by the FMA-UE improved by an average of 4.2 points (p < 0.001) following
upper extremity BCI
treatment. In addition, improvements in
activities of daily living and clinically relevant improvements in
hand and
finger spasticity were observed.
Patients showed further improvements after the
lower extremity BCI
treatment, with
walking speed as measured by the 10MWT increasing by 0.15 m/s (p = 0.001), reflecting a substantial meaningful change. Furthermore, a clinically relevant improvement in
ankle spasticity and balance and mobility were observed.
Discussion:
The results of the current study provide evidence that both upper and
lower extremity BCI
treatments, as well as their combination, are effective in facilitating functional improvements after
stroke. In addition, and most importantly improvements did not stop after the first 25
upper extremity BCI sessions.