BACKGROUND: There is no accepted and efficient rehabilitation strategy to reduce focal impairments for patients with chronic stroke who lack residual movements. METHODS: A 67-year-old hemiplegic patient with no active finger extension was trained with a brain-computer interface (BCI) combined with a specific daily life-oriented physiotherapy. The BCI used electrical brain activity (EEG) and magnetic brain activity (MEG) to drive an orthosis and a robot affixed to the patient's affected upper extremity, which enabled him to move the paralyzed arm and hand driven by voluntary modulation of micro-rhythm activity. In addition, the patient practiced goal-directed physiotherapy training. Over 1 year, he completed 3 training blocks. Arm motor function, gait capacities (using Fugl-Meyer Assessment, Wolf Motor Function Test, Modified Ashworth Scale, 10-m walk speed, and goal attainment score), and brain reorganization (functional MRI, MEG) were repeatedly assessed. RESULTS: The ability of hand and arm movements as well as speed and safety of gait improved significantly (mean 46.6%). Improvement of motor function was associated with increased micro-oscillations in the ipsilesional motor cortex. CONCLUSION: This proof-of-principle study suggests that the combination of BCI training with goal-directed, active physical therapy may improve the motor abilities of chronic stroke patients despite apparent initial paralysis.
BACKGROUND: There is no accepted and efficient rehabilitation strategy to reduce focal impairments for patients with chronic stroke who lack residual movements. METHODS: A 67-year-old hemiplegic patient with no active finger extension was trained with a brain-computer interface (BCI) combined with a specific daily life-oriented physiotherapy. The BCI used electrical brain activity (EEG) and magnetic brain activity (MEG) to drive an orthosis and a robot affixed to the patient's affected upper extremity, which enabled him to move the paralyzed arm and hand driven by voluntary modulation of micro-rhythm activity. In addition, the patient practiced goal-directed physiotherapy training. Over 1 year, he completed 3 training blocks. Arm motor function, gait capacities (using Fugl-Meyer Assessment, Wolf Motor Function Test, Modified Ashworth Scale, 10-m walk speed, and goal attainment score), and brain reorganization (functional MRI, MEG) were repeatedly assessed. RESULTS: The ability of hand and arm movements as well as speed and safety of gait improved significantly (mean 46.6%). Improvement of motor function was associated with increased micro-oscillations in the ipsilesional motor cortex. CONCLUSION: This proof-of-principle study suggests that the combination of BCI training with goal-directed, active physical therapy may improve the motor abilities of chronic strokepatients despite apparent initial paralysis.
Authors: Natalie Mrachacz-Kersting; Ning Jiang; Andrew James Thomas Stevenson; Imran Khan Niazi; Vladimir Kostic; Aleksandra Pavlovic; Sasa Radovanovic; Milica Djuric-Jovicic; Federica Agosta; Kim Dremstrup; Dario Farina Journal: J Neurophysiol Date: 2015-12-30 Impact factor: 2.714
Authors: Surjo R Soekadar; Matthias Witkowski; Jürgen Mellinger; Ander Ramos; Niels Birbaumer; Leonardo G Cohen Journal: IEEE Trans Neural Syst Rehabil Eng Date: 2011-10 Impact factor: 3.802
Authors: S L Norman; D J McFarland; A Miner; S C Cramer; E T Wolbrecht; J R Wolpaw; D J Reinkensmeyer Journal: J Neural Eng Date: 2018-07-31 Impact factor: 5.379