Feasibility of task-specific brain-machine interface training for upper-extremity paralysis in patients with chronic hemiparetic stroke
Atsuko Nishimoto, Michiyuki Kawakami, Toshiyuki Fujiwara, Miho Hiramoto, Kaoru Honaga, Kaoru Abe, Katsuhiro Mizuno, Junichi Ushiba, Meigen Liu
Department of Rehabilitation Medicine, Keio University School of Medicine, Japan
Objective: Brain-machine interface training was developed for upper-extremity rehabilitation for patients with severe hemiparesis. Its clinical application, however, has been limited because of its lack of feasibility in real-world rehabilitation settings. We developed a new compact task-specific brain-machine interface system that enables task-specific training, including reach-and-grasp tasks, and studied its clinical feasibility and effectiveness for upper-extremity motor paralysis in patients with stroke.
Design: Prospective beforeâ€“after study.
Subjects: Twenty-six patients with severe chronic hemiparetic stroke.
Methods: Participants were trained with the brain-machine interface system to pick up and release pegs during 40-min sessions and 40 min of standard occupational therapy per day for 10 days. Fugl-Meyer upper-extremity motor (FMA) and Motor Activity Log-14 amount of use (MAL-AOU) scores were assessed before and after the intervention. To test its feasibility, 4 occupational therapists who operated the system for the first time assessed it with the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST) 2.0.
Results: FMA and MAL-AOU scores improved significantly after brain-machine interface training, with the effect sizes being medium and large, respectively (p<0.01, d=0.55; p<0.01, d=0.88). QUEST effectiveness and safety scores showed feasibility and satisfaction in the clinical setting.
Conclusion: Our newly developed compact brain-machine interface system is feasible for use in real-world clinical settings.
Brain machine interface (BMI) is a novel tool for rehabilitation. It detects brain signals and provides the movement in the paretic limb. We developed a new compact BMI system, available in clinical setting. Twenty-six patients with chronic severe hemiparesis following stroke were trained to pick up and release pegs for 10 days. The training improved motor function and, thus, our newly developed task-specific BMI is useful in clinical practice of stroke rehabilitation.