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Zanona ADF, Piscitelli D, Seixas VM, Scipioni KRDDS, Bastos MSC, de Sá LCK, Monte-Silva K, Bolivar M, Solnik S, De Souza RF. Brain-computer interface combined with mental practice and occupational therapy enhances upper limb motor recovery, activities of daily living, and participation in subacute stroke. Front Neurol 2023; 13:1041978. [PMID: 36698872 PMCID: PMC9869053 DOI: 10.3389/fneur.2022.1041978] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 11/28/2022] [Indexed: 01/11/2023] Open
Abstract
Background We investigated the effects of brain-computer interface (BCI) combined with mental practice (MP) and occupational therapy (OT) on performance in activities of daily living (ADL) in stroke survivors. Methods Participants were randomized into two groups: experimental (n = 23, BCI controlling a hand exoskeleton combined with MP and OT) and control (n = 21, OT). Subjects were assessed with the functional independence measure (FIM), motor activity log (MAL), amount of use (MAL-AOM), and quality of movement (MAL-QOM). The box and blocks test (BBT) and the Jebsen hand functional test (JHFT) were used for the primary outcome of performance in ADL, while the Fugl-Meyer Assessment was used for the secondary outcome. Exoskeleton activation and the degree of motor imagery (measured as event-related desynchronization) were assessed in the experimental group. For the BCI, the EEG electrodes were placed on the regions of FC3, C3, CP3, FC4, C4, and CP4, according to the international 10-20 EEG system. The exoskeleton was placed on the affected hand. MP was based on functional tasks. OT consisted of ADL training, muscle mobilization, reaching tasks, manipulation and prehension, mirror therapy, and high-frequency therapeutic vibration. The protocol lasted 1 h, five times a week, for 2 weeks. Results There was a difference between baseline and post-intervention analysis for the experimental group in all evaluations: FIM (p = 0.001, d = 0.56), MAL-AOM (p = 0.001, d = 0.83), MAL-QOM (p = 0.006, d = 0.84), BBT (p = 0.004, d = 0.40), and JHFT (p = 0.001, d = 0.45). Within the experimental group, post-intervention improvements were detected in the degree of motor imagery (p < 0.001) and the amount of exoskeleton activations (p < 0.001). For the control group, differences were detected for MAL-AOM (p = 0.001, d = 0.72), MAL-QOM (p = 0.013, d = 0.50), and BBT (p = 0.005, d = 0.23). Notably, the effect sizes were larger for the experimental group. No differences were detected between groups at post-intervention. Conclusion BCI combined with MP and OT is a promising tool for promoting sensorimotor recovery of the upper limb and functional independence in subacute post-stroke survivors.
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Affiliation(s)
- Aristela de Freitas Zanona
- Department of Occupational Therapy and Graduate Program in Applied Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil,*Correspondence: Aristela de Freitas Zanona ✉
| | - Daniele Piscitelli
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy,Department of Kinesiology, University of Connecticut, Storrs, CT, United States
| | - Valquiria Martins Seixas
- Department of Occupational Therapy and Graduate Program in Applied Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
| | | | | | | | - Kátia Monte-Silva
- Department of Physical Therapy, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Miburge Bolivar
- Department of Occupational Therapy and Graduate Program in Applied Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
| | - Stanislaw Solnik
- Department of Physical Therapy, University of North Georgia, Dahlonega, GA, United States,Department of Physical Education, Wroclaw University of Health and Sport Sciences, Wroclaw, Poland
| | - Raphael Fabricio De Souza
- Department of Occupational Therapy and Graduate Program in Applied Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
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Borisova VA, Isakova EV, Kotov SV. [Possibilities of the brain-computer interface in the correction of post-stroke cognitive impairments]. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:60-66. [PMID: 36582163 DOI: 10.17116/jnevro202212212260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
In recent years, brain-computer interfaces have been widely used in neurorehabilitation, and an extensive database of results from clinical studies conducted around the world has been accumulated, demonstrating their effectiveness in restoring motor function after a stroke. Currently, their use in post-stroke cognitive impairment is expanding. This article discusses the potential and prospects for using brain-computer interfaces for the treatment of cognitive disorders, reviews the experience of using it, presents the results of clinical studies in stroke patients, evaluates the possibilities of using this technology, describes the prospects, new directions of work on studying its effects.
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Affiliation(s)
- V A Borisova
- Vladimirskii Moscow Regional Research Clinical Institute, Moscow, Russia
| | - E V Isakova
- Vladimirskii Moscow Regional Research Clinical Institute, Moscow, Russia
| | - S V Kotov
- Vladimirskii Moscow Regional Research Clinical Institute, Moscow, Russia
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