Despite encouraging results, motor rehabilitation based on BMIs is still in a preliminary stage, and further improvements are required to boost its efficacy. Invasive and hybrid approaches are promising and might set the stage for the next generation of stroke rehabilitation therapies.

Objective. Brain–computer-interfaces (BCIs) have been proposed not only as assistive technologies but also as rehabilitation tools for lost functions. However, due to the stochastic nature, poor spatial resolution and signal to noise ratio from electroencephalography (EEG), multidimensional decoding has been the main obstacle to implement non-invasive BCIs in real-live rehabilitation scenarios. This study explores the classification of several functional reaching movements from the same limb using EEG oscillations in order to create a more versatile BCI for rehabilitation. Approach. Nine healthy participants performed four 3D center-out reaching tasks in four different sessions while wearing a passive robotic exoskeleton at their right upper limb. Kinematics data were acquired from the robotic exoskeleton. Multiclass extensions of Filter Bank Common Spatial Patterns (FBCSP) and a linear discriminant analysis (LDA) classifier were used to classify the EEG activity into four forward reaching movements (from a starting position towards four target positions), a backward movement (from any of the targets to the starting position and rest). Recalibrating the classifier using data from previous or the same session was also investigated and compared. Main results. Average EEG decoding accuracy were significantly above chance with 67%, 62.75%, and 50.3% when decoding three, four and six tasks from the same limb, respectively. Furthermore, classification accuracy could be increased when using data from the beginning of each session as training data to recalibrate the classifier. Significance. Our results demonstrate that classification from several functional movements performed by the same limb is possible with acceptable accuracy using EEG oscillations, especially if data from the same session are used to recalibrate the classifier. Therefore, an ecologically valid decoding could be used to control assistive or rehabilitation mutli-degrees of freedom (DoF) robotic devices using EEG data. These results have important implications towards assistive and rehabilitative neuroprostheses control in paralyzed patients.

Including supplementary information from the brain or other body parts in the control of brain-machine interfaces (BMIs) has been recently proposed and investigated. Such enriched interfaces are referred to as hybrid BMIs (hBMIs) and have been proven to be more robust and accurate than regular BMIs for assistive and rehabilitative applications. Electromyographic (EMG) activity is one of the most widely utilized biosignals in hBMIs, as it provides a quite direct measurement of the motion intention of the user. Whereas most of the existing non-invasive EEG-EMG-hBMIs have only been subjected to offline testings or are limited to one degree of freedom (DoF), we present an EEG-EMG-hBMI that allows the simultaneous control of 7-DoFs of the upper limb with a robotic exoskeleton. Moreover, it establishes a biologically-inspired hierarchical control flow, requiring the active participation of central and peripheral structures of the nervous system. Contingent visual and proprioceptive feedback about the user's EEG and EMG activity is provided in the form of velocity modulation during functional task training. We believe that training with this closed-loop system may facilitate functional neuroplastic processes and eventually elicit a joint brain and muscle motor rehabilitation. Its usability is validated during a real-time operation session in a healthy participant and a chronic stroke patient, showing encouraging results for its application to a clinical rehabilitation scenario.

The motor impairment occurring after a stroke is characterized by pathological muscle activation patterns or synergies. However, while robot-aided myoelectric interfaces have been proposed for stroke rehabilitation, they do not address this issue, which might result in inefficient interventions. Here, we present a novel paradigm that relies on the correction of the pathological muscle activity as a way to elicit rehabilitation, even in patients with complete paralysis. Previous studies demonstrated that there are no substantial inter-limb differences in the muscle synergy organization of healthy individuals. We propose building a subject-specific model of muscle activity from the healthy limb and mirroring it to use it as a learning tool for the patient to reproduce the same healthy myoelectric patterns on the paretic limb during functional task training. Here, we aim at understanding how this myoelectric model, which translates muscle activity into continuous movements of a 7-degree of freedom upper limb exoskeleton, could transfer between sessions, arms and tasks. The experiments with 8 healthy individuals and 2 chronic stroke patients proved the feasibility and effectiveness of such myoelectric interface. We anticipate the proposed method to become an efficient strategy for the correction of maladaptive muscle activity and the rehabilitation of stroke patients.