Rehabilitation of hand in subacute tetraplegic patients based on brain computer interface and functional electrical stimulation: a randomised pilot study

Abstract

View the article online for updates and enhancements. Objective. To compare neurological and functional outcomes between two groups of hospitalised patients with subacute tetraplegia. Approach. Seven patients received 20 sessions of brain computer interface (BCI) controlled functional electrical stimulation (FES) while five patients received the same number of sessions of passive FES for both hands. The neurological assessment measures were event related desynchronization (ERD) during movement attempt, Somatosensory evoked potential (SSEP) of the ulnar and median nerve; assessment of hand function involved the range of motion (ROM) of wrist and manual muscle test. Main results. Patients in both groups initially had intense ERD during movement attempt that was not restricted to the sensory-motor cortex. Following the treatment, ERD cortical activity restored towards the activity in able-bodied people in BCI-FES group only, remaining wide-spread in FES group. Likewise, SSEP returned in 3 patients in BCI-FES group, having no changes in FES group. The ROM of the wrist improved in both groups. Muscle strength significantly improved for both hands in BCI-FES group. For FES group, a significant improvement was noticed for right hand flexor muscles only. Significance. Combined BCI-FES therapy results in better neurological recovery and better improvement of muscle strength than FES alone. For spinal cord injured patients, BCI-FES should be considered as a therapeutic tool rather than solely a long-term assistive device for the restoration of a lost function.

Home-based rehabilitation using a soft robotic hand glove device leads to improvement in hand function in people with chronic spinal cord injury:a pilot study

“…The SEM Glove is designed to encourage active engagement in a motor task. This is essential to achieve improved voluntary motor control mediated by the motor cortex [38,39], and also provides feedback to the sensorimotor system [38,[40][41][42][43]. Its use may therefore potentially lead to motor learning due to neuroplasticity [40,43].…”

Unimanual Versus Bimanual Motor Imagery Classifiers for Assistive and Rehabilitative Brain Computer Interfaces

“…RAIN computer interface (BCI) based on motor imagination (MI) has wide range of applications, spanning from spellers to assistive devices [1][2][3][4][5][6][7]. Yet MI BCI has most often been used as a part of rehabilitative and assistive systems to repair or restore motor functions.…”

“…A Vuckovic is with the Biomedical Engineering, School of Engineering, University of Glasgow, G12 8QQ, UK (email: Aleksandra.vuckovic@glasgow.ac.uk). extremities in stroke patients and patients with incomplete spinal cord injury [4][5][6] and assistive devices for people with complete high level spinal cord injury (tetraplegia) for restoration of motor functions [2,3].…”

“…Although many activities of daily living require use of both hands [8], most MI BCI rehabilitation systems have been designed to assist single limb movements [1][2][3][4][5][6][7]. Applications range from the detection of MI of different limbs to detection of direction, speed and target location of a single limb [9][10][11][12].…”

“…People with complete tetraplegia, who have bilateral upper limb paralysis, would benefit from assistive devices that would allow a selection between uni-and bimanual tasks, enabling wider range of motor tasks, increasing patients' independence. Combined unilateral and bilateral BCI-FES assisted movements could also be used in rehabilitation of movement in patients with incomplete subacute tetraplegia, because they require therapy of both hands [5].…”