Online Covariate Shift Detection-Based Adaptive Brain–Computer Interface to Trigger Hand Exoskeleton Feedback for Neuro-Rehabilitation

Aim - to evaluate the efficiency of the motor recovery rehabilitation procedure with the use of hand exoskeleton controlled by the brain-computer interface (BCI). Materials and methods. 60 post-stroke patients participated in the study. 46 patients had ischemic stroke and 14 had hemorrhagic stroke. 42 patients of the main experimental group were trained in kinesthetic motor imagery using hand exoskeleton controlled by BCI, 18 patients of the control group carried out the imitating procedure. Exoskeleton - BCI system consists of encephalograph NVX52 («Medical Computer Systems», Russia), personal computer and hand exoskeleton («Android Technique», Russia). Motor functions were estimated by neurological scales ARAT and Fugl-Meyer. Results were statistically analyzed by Mann-Whitney, Wilcoxon and x2 tests, Spearman's correlation and RM-ANOVA using Statsoft Statistica v. 6.0. Results. It is shown that post-stroke patients are able to control BCI with the same efficiency as healthy subjects, regardless of the duration, severity and localization of the disease. Ten days of BCI training significantly improved patients’ motor functions according to neurological scales ARAT and Fugl-Meyer. Improvement was mainly provided by the small movements of the hand. According to several sections of neurological scales, improvement in the main group is significantly higher than in the control group. However, according to general scores, statistically significant difference between two groups was not observed. Conclusion. It is shown that the rehabilitation procedure using hand exsoskeleton controlled by BCI significantly improves motor functions of the paretic arm regardless of the duration, severity and localization of the disease. Increase of the training duration enhances the rehabilitation efficiency.

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Rehabilitation of patients with cerebral palsy using hand exoskeleton controlled by brain-computer interface

Bulletin of Russian State Medical University ◽

10.24075/brsmu.2020.047 ◽

2020 ◽

pp. 33-40

Author(s):

PD Bobrov ◽

EV Biryukova ◽

BA Polyaev ◽

OA Lajsheva ◽

EL Usachjova ◽

...

Keyword(s):

Cerebral Palsy ◽

Motor Function ◽

Motor Imagery ◽

Brain Computer Interface ◽

Motor Impairment ◽

Assessment Scale ◽

Computer Interface ◽

Mu Rhythm ◽

Function Test ◽

Hand Exoskeleton

Cerebral palsy (CP) is one of the most severe central nervous system diseases in childhood associated with motor impairment. The study was aimed to assess the efficiency of the complex comprising brain-computer interface (BCI) and hand exoskeleton as an instrument for the motor function recovery in patients with CP complementing the essential therapy. The Fugl-Meyer Assessment scale, ARAT test and Jebsen–Taylor function test were used in 14 children and adolescents for the motor function improvement assessment after the therapy complemented by 7–10 BCI-exoskeleton based procedures. The EEG mu-rhythm sources properties during the motor imagery BCI control were studied. After the procedures completion, the significant improvement of the Fugl-Meyer Assessment scale score (7 (2; 11) for hand active movements; 4.5 (1; 6) for proximal arm and 2.5 (0; 5) for hand), ARAT test score (7.5 (1; 31) for total score, 1.5 (0; 12) for grasp movement and 1.5 (0; 8) for grip movement), as well as significantly different from the zero execution time reduction in three out of seven Jabsen–Taylor function test items (–1 (–4.13; 0.25) for simulated feeding; –1 (–2; 0) for moving light and heavy cans) were identified. The average BCI detection level was 0.51 (0.45; 0.54) (max = 0.70). In most EEG recordings the mu-rhythm sources were detected, both for intact and affected hemispheres. The mu-rhythm desynchronization associated with motor imagery was observed, significantly affecting the BCI accuracy. The results obtained indicate that the use of BCI-exoskeleton complex effectively complements the standard rehabilitation methods for children with CP, and suggest that its clinical effectiveness in individuals with CP may be proven by enrollment of more patients.

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