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

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 n...

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Bibliographic Details
Published in:Journal of neural engineering 2016-12, Vol.13 (6), p.065002-065002
Main Authors: Osuagwu, Bethel C A, Wallace, Leslie, Fraser, Mathew, Vuckovic, Aleksandra
Format: Article
Language:English
Subjects:
Adult
Aged
brain computer interface
Brain-Computer Interfaces
Electric Stimulation
Electroencephalography Phase Synchronization
Evoked Potentials, Somatosensory
functional electrical stimulation
Hand
Humans
Male
Median Nerve - physiopathology
Middle Aged
Movement
Muscle Strength
Pilot Projects
Quadriplegia - physiopathology
Quadriplegia - rehabilitation
Range of Motion, Articular
rehabilitation
Sensorimotor Cortex - physiopathology
tetraplegia
Ulnar Nerve - physiopathology
Wrist - physiology
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Summary: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.
ISSN:1741-2560
1741-2552
DOI:10.1088/1741-2560/13/6/065002