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
DOI: 10.2340/16501977-2275

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 before–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.