Brain-Computer Interfaces Systems for Upper and Lower Limb Rehabilitation: A Systematic Review

Abstract

In recent years, various studies have demonstrated the potential of electroencephalographic (EEG) signals for the development of brain-computer interfaces (BCIs) in the rehabilitation of human limbs. This article is a systematic review of the state of the art and opportunities in the development of BCIs for the rehabilitation of upper and lower limbs of the human body. The systematic review was conducted in databases considering using EEG signals, interface proposals to rehabilitate upper/lower limbs using motor intention or movement assistance and utilizing virtual environments in feedback. Studies that did not specify which processing system was used were excluded. Analyses of the design processing or reviews were excluded as well. It was identified that 11 corresponded to applications to rehabilitate upper limbs, six to lower limbs, and one to both. Likewise, six combined visual/auditory feedback, two haptic/visual, and two visual/auditory/haptic. In addition, four had fully immersive virtual reality (VR), three semi-immersive VR, and 11 non-immersive VR. In summary, the studies have demonstrated that using EEG signals, and user feedback offer benefits including cost, effectiveness, better training, user motivation and there is a need to continue developing interfaces that are accessible to users, and that integrate feedback techniques.

Identifying Thematics in a Brain‐Computer Interface Research

“…These terms include “signal possessing” or “signal analysis” [ 6 , 7 , 19 , 52 ]. Medical-associated words such as “stroke” and “rehabilitation” were seen to remain in use [ 64 , 71 , 76 , 78 , 85 ]; this is reflected in the shift of focus from understanding how the brain functions after a stroke to more practical applications identifying functional brain pathways using“motor imagery” [ 7 , 36 , 70 , 79 , 89 ] and its practical application with “upper limb” [ 84 , 85 ], or “upper extremity” [ 86 ] and “lower limb” [ 84 ].…”

“…EEG has also been used to detect mental commands for the operation of wheelchairs after spinal cord injury or neuromuscular disease and has extensively been used in stroke rehabilitation and external device control [35,43]. EEG systems in stroke victims have been efective in returning upper body control after rehabilitation [76,[83][84][85][86].…”

Integration of Inertial Sensors in a Lower Limb Robotic Exoskeleton

“…The sensors that capture motion are placed on the thigh and knee segments, including the electrodes for capturing the muscle electromyographic activity, and are wirelessly connected to a central processing unit called Imocap-GIS; this system is visualized in Figure 2. In addition to providing the position of the joints accurately and real-time data acquired at a speed of 90 samples per second (samples/s) [25], the Imocap-GIS system also enables the operator to calculate the linear acceleration and angular speed of the movements in three pre-established axes (x, y, and z) in a precise and reliable way [26]. It is, therefore, a satisfactory tool to be integrated into the exoskeleton.…”

A Review of Brain Activity and EEG-Based Brain–Computer Interfaces for Rehabilitation Application

“…Several review papers have been published on the BCI rehabilitation system [ 28 , 29 , 30 , 31 ]. But few of these papers have described in detail the applications of the BCI system in different fields, how the BCI concept was applied to these systems, the drive modes, and the control strategies.…”