Brain Computer Interface treatment for gait rehabilitation of stroke patients – Preliminary results

Abstract

Neurorehabilitation based on Brain-Computer Interfaces (BCIs) show important rehabilitation effects for patients after stroke. Previous studies have shown improvements for patients that are in a chronic stage and/or have severe hemiparesis and are particularly challenging for conventional rehabilitation techniques. Seven stroke patients in chronic phase with lower extremity hemiparesis were recruited. All of them participated in 25 BCI-sessions about 3 times/week. The BCI-system was based on the Motor Imagery (MI) of the paretic-ankle dorsiflexion and healthy-wrist dorsiflexion with Functional Electrical Stimulation (FES) and avatar feedback. Assessments were conducted to assess the changes before and after the therapy. The functional scales used were: 10-meters walking test (10MWT), Range of Motion (ROM) of the ankle dorsiflexion and Timed Up and Go (TUG). Results show a significant increase in the gait speed in the primary measure 10MWT self-velocity of 0.14 m/s (SD = 0.10). This improvement is above of the minimally clinically important difference. The speed in the TUG also significantly increased by 0.08 m/s, P = 0.016. The range of motion also was increased after the therapy, ΔROM passive= 8.83° (SD = 7.22), P=0.016, and ΔROM active = 7.14° (SD = 4.84), P= 0.016. These outcomes show the feasibility of this BCI approach, and further support the growing consensus that these types of tools might develop into a new paradigm for gait rehabilitation tool for stroke patients. However, the results are from seven chronic stroke patients so the authors believe that this approach should be further validated in broader studies involving more patients.