Study design Feasibility and preliminary clinical efficacy analysis in a single-arm interventional study. Objectives We developed a brain-computer interface-triggered functional electrical stimulation therapy (BCI-FEST) system for clinical application and conducted an interventional study to (1) assess its feasibility and (2) understand its potential clinical efficacy for the rehabilitation of reaching and grasping in individuals with sub-acute spinal cord injury (SCI). Setting Spinal cord injury rehabilitation hospital-Toronto Rehabilitation Institute-Lyndhurst Centre. Methods Five participants with sub-acute SCI completed between 12 and 40 1-hour sessions using BCI-FEST, with up to 5 sessions a week. We assessed feasibility by measuring participants' compliance with treatment, the occurrence of adverse events, BCI sensitivity, and BCI setup duration. Clinical efficacy was assessed using Functional Independence Measure (FIM) and Spinal Cord Independence Measure (SCIM), as primary outcomes. In addition, we used two upper-limb function tests as secondary outcomes. Results On average, participants completed 29.8 sessions with no adverse events. Only one of the 149 sessions was affected by technical challenges. The BCI sensitivity ranged between 69.5 and 80.2%, and the mean BCI setup duration was ~11 min. In the primary outcomes, three out of five participants showed changes greater than the minimal clinically important differences (MCIDs). Additionally, the mean change in secondary outcome measures met the threshold for detecting MCID as well; four out of five participants achieved MCID. Conclusions The new BCI-FEST intervention is safe, feasible, and promising for the rehabilitation of reaching and grasping after SCI.

No abstract

No abstract

Study design An exploratory descriptive study was conducted. Objective To determine if and how occupational therapists (OTs) and physical therapists (PTs) in acute care hospital settings use activity-based therapy (ABT) and its associated technologies. Setting Acute care hospital settings in Canada. Methods Semi-structured interviews were conducted with physical and occupational therapists, licensed in Canada, who worked in an acute care neurological setting with individuals with spinal cord injury or disease (SCI/D). To analyze the data, interpretive description was used. NVivo 12 was used for data management. Results Five physical therapists and two occupational therapists were interviewed ( n = 7). Two therapists declined after reading a description of the study. Through analysis, the following themes were identified as affecting the delivery of ABT as part of SCI/D rehabilitation in the acute care setting: (1) Impact of patient acuity on ABT participation, (2) ABT approach unique to the acute care setting, and (3) Influence of acute care work environment and therapy practice. Throughout these themes, therapists referred to dosage as a limiting factor affecting ABT delivery. Conclusions Our research reveals that implementing ABT in an acute care setting is challenging considering the high dosage of movement practice required for ABT. To increase dosage and the use of ABT in acute care, strategies could include early patient education on ABT, strategic use of social supports, and use of portable technology already incorporated in acute care.

No abstract

Purpose: While current rehabilitation practice for improving arm and hand function relies on physical/occupational therapy, a growing body of research evaluates the effects of technology-enhanced rehabilitation. We review interventions that combine a brain-computer interface (BCI) with electrical stimulation (ES) for upper limb movement rehabilitation to summarize the evidence on (1) populations of study participants, (2) BCI-ES interventions, and (3) the BCI-ES systems. Method: After searching seven databases, two reviewers identified 23 eligible studies. We consolidated information on the study participants, interventions, and approaches used to develop integrated BCI-ES systems. The included studies investigated the use of BCI-ES interventions with stroke and spinal cord injury (SCI) populations. All studies used electroencephalography to collect brain signals for the BCI, and functional electrical stimulation was the most common type of ES. The BCI-ES interventions were typically conducted without a therapist, with sessions varying in both frequency and duration. Results: Of the 23 eligible studies, only 3 studies involved the SCI population, compared to 20 involving individuals with stroke. Conclusions: Future BCI-ES interventional studies could address this gap. Additionally, standardization of device and rehabilitation modalities, and study-appropriate involvement with therapists, can be considered to advance this intervention towards clinical implementation.

No abstract

No abstract