Dataset Information

BCI system with lower-limb robot improves rehabilitation in spinal cord injury patients through short-term training: a pilot study.

ABSTRACT: In the recent years, the increasing applications of brain-computer interface (BCI) in rehabilitation programs have enhanced the chances of functional recovery for patients with neurological disorders. We presented and validated a BCI system with a lower-limb robot for short-term training of patients with spinal cord injury (SCI). The cores of this system included: (1) electroencephalogram (EEG) features related to motor intention reported through experiments and used to drive the robot; (2) a decision tree to determine the training mode provided for patients with different degrees of injuries. Seven SCI patients (one American Spinal Injury Association Impairment Scale (AIS) A, three AIS B, and three AIS C) participated in the short-term training with this system. All patients could learn to use the system rapidly and maintained a high intensity during the training program. The strength of the lower limb key muscles of the patients was improved. Four AIS A/B patients were elevated to AIS C. The cumulative results indicate that clinical application of the BCI system with lower-limb robot is feasible and safe, and has potentially positive effects on SCI patients.

Supplementary information

The online version contains supplementary material available at 10.1007/s11571-022-09801-6.

SUBMITTER: Cui Z

PROVIDER: S-EPMC9666612 | biostudies-literature | 2022 Dec

REPOSITORIES: biostudies-literature

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BCI system with lower-limb robot improves rehabilitation in spinal cord injury patients through short-term training: a pilot study.

Cui Zhengzhe Z Li Yongqiang Y Huang Sisi S Wu Xixi X Fu Xiangxiang X Liu Fei F Wan Xiaojiao X Wang Xue X Zhang Yuting Y Qiu Huaide H Chen Fang F Yang Peijin P Zhu Shiqiang S Li Jianan J Chen Weidong W

Cognitive neurodynamics 20220410 6

In the recent years, the increasing applications of brain-computer interface (BCI) in rehabilitation programs have enhanced the chances of functional recovery for patients with neurological disorders. We presented and validated a BCI system with a lower-limb robot for short-term training of patients with spinal cord injury (SCI). The cores of this system included: (1) electroencephalogram (EEG) features related to motor intention reported through experiments and used to drive the robot; (2) a de ...[more]

PMID: 36408074

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Project description:BACKGROUND:Powered exoskeleton can improve the mobility for people with movement deficits by providing mechanical support and facilitate the gait training. This pilot study evaluated the effect of gait training using a newly developed powered lower limb exoskeleton robot for individuals with complete spinal cord injury (SCI). METHODS:Two participants with a complete SCI were recruited for this clinical study. The powered exoskeleton gait training was 8 weeks, 1 h per session, and 2 sessions per week. The evaluation was performed before and after the training for (1) the time taken by the user to don and doff the powered exoskeleton independently, (2) the level of exertion perceived by participants while using the powered exoskeleton, and (3) the mobility performance included the timed up-and-go test, 10-m walk test, and 6-min walk test with the powered exoskeleton. The safety of the powered exoskeleton was evaluated on the basis of injury reports and the incidence of falls or imbalance while using the device. RESULTS:The results indicated that the participants were donning and doffing the powered lower limb exoskeleton robot independently with a lower level of exertion and walked faster and farther without any injury or fall incidence when using the powered exoskeleton than when using a knee-ankle-foot orthosis. Bone mineral densities was also increased after the gait training. No adverse effects, such as skin abrasions, or discomfort were reported while using the powered exoskeleton. CONCLUSIONS:The findings demonstrated that individuals with complete SCI used the powered lower limb exoskeleton robot independently without any assistance after 8 weeks of powered exoskeleton gait training. TRIAL REGISTRATION:Trial registration: National Taiwan University Hospital. TRIAL REGISTRATION NUMBER:201210051RIB . Name of registry: Hui-Fen Mao. URL of registry: Not available. Date of registration: December 12th, 2012. Date of enrolment of the first participant to the trial: January 3rd, 2013.

Project description:Key factors positively influencing rehabilitation and functional recovery after spinal cord injury (SCI) include training variety, intensive movement repetition, and motivating training tasks. Systems supporting these aspects may provide profound gains in rehabilitation, independent of the subject's treatment location. In the present study, we test the hypotheses that virtual reality (VR)-augmented training at home (i.e., unsupervised) is feasible with subjects with an incomplete SCI (iSCI) and that it improves motor functions such as lower limb muscle strength, balance, and functional mobility. In the study, 12 chronic iSCI subjects used a home-based, mobile version of a lower limb VR training system. The system included motivating training scenarios and combined action observation and execution. Virtual representations of the legs and feet were controlled via movement sensors. The subjects performed home-based training over 4 weeks, with 16-20 sessions of 30-45 min each. The outcome measures assessed were the Lower Extremity Motor Score (LEMS), Berg Balance Scale (BBS), Timed Up and Go (TUG), Spinal Cord Independence Measure mobility, Walking Index for Spinal Cord Injury II, and 10 m and 6 min walking tests. Two pre-treatment assessment time points were chosen for outcome stability: 4 weeks before treatment and immediately before treatment. At post-assessment (i.e., immediately after treatment), high motivation and positive changes were reported by the subjects (adapted Patients' Global Impression of Change). Significant improvements were shown in lower limb muscle strength (LEMS, P = 0.008), balance (BBS, P = 0.008), and functional mobility (TUG, P = 0.007). At follow-up assessment (i.e., 2-3 months after treatment), functional mobility (TUG) remained significantly improved (P = 0.005) in contrast to the other outcome measures. In summary, unsupervised exercises at home with the VR training system led to beneficial functional training effects in subjects with chronic iSCI, suggesting that it may be useful as a neurorehabilitation tool.Trial registrationCanton of Zurich ethics committee (EK-24/2009, PB_2016-00545), ClinicalTrials.gov: NCT02149186. Registered 24 April 2014.

Project description:ObjectiveWe aim to determine a comprehensive set of requirements, perceptions, and expectations that people with spinal cord injury (SCI) and the clinicians in charge of their rehabilitation have regarding the use of wearable robots (WR) for gait rehabilitation.BackgroundThere are concerns due to the limited user acceptance of WR for gait rehabilitation. Developers need to emphasize understanding the needs and constraints of all stakeholders involved, including the real-life dynamics of rehabilitation centers.Methods15 people with SCI, 9 without experience with WR and 6 with experience with these technologies, and 10 clinicians from 3 rehabilitation centers in Spain were interviewed. A directed content analysis approach was used.Results78 codes grouped into 9 categories (physical results, usability, psychology-related codes, technical characteristics, activities, acquisition issues, context of use, development of the technologies and clinical rehabilitation context) were expressed by at least 20% of the users interviewed, of whom 16 were not found in the literature. The agreement percentage between each group and subgroup included in the study, calculated as the number of codes that more than 20% of both groups expressed, divided over the total amount of codes any of those two groups agreed on (≥ 20%), showed limited agreement between patients and clinicians (50.00%) and between both types of patients (55.77%). The limited accessibility and availability of lower limb exoskeletons for gait rehabilitation arose in most of the interviews.ConclusionsThe limited agreement percentage between patients and clinicians indicates that including both types of users in the design process of these technologies is important, given that their requirements are complementary. Engaging users with prior technology experience is recommended, as they often exhibit strong internal consensus and articulate well-defined requirements. This study adds up the knowledge available in the literature and the new codes found in our data, which enlighten important aspects that ought to be addressed in the field to develop technologies that respond to users' needs, are usable and feasible to implement in their intended contexts.ApplicationThe set of criteria summarized in our study will be useful to guide the design, development, and evaluation of WR for gait rehabilitation to meet user's needs and allow them to be implemented in their intended context of use.

Project description:BackgroundIn combined with neurofeedback, Motor Imagery (MI) based Brain-Computer Interface (BCI) has been an effective long-term treatment therapy for motor dysfunction caused by neurological injury in the brain (e.g., post-stroke hemiplegia). However, individual neurological differences have led to variability in the single sessions of rehabilitation training. Research on the impact of short training sessions on brain functioning patterns can help evaluate and standardize the short duration of rehabilitation training. In this paper, we use the electroencephalogram (EEG) signals to explore the brain patterns' changes after a short-term rehabilitation training.Materials and methodsUsing an EEG-BCI system, we analyzed the changes in short-term (about 1-h) MI training data with and without visual feedback, respectively. We first examined the EEG signal's Mu band power's attenuation caused by Event-Related Desynchronization (ERD). Then we use the EEG's Event-Related Potentials (ERP) features to construct brain networks and evaluate the training from multiple perspectives: small-scale based on single nodes, medium-scale based on hemispheres, and large-scale based on all-brain.ResultsResults showed no significant difference in the ERD power attenuation estimation in both groups. But the neurofeedback group's ERP brain network parameters had substantial changes and trend properties compared to the group without feedback. The neurofeedback group's Mu band power's attenuation increased but not significantly (fitting line slope = 0.2, t-test value p > 0.05) after the short-term MI training, while the non-feedback group occurred an insignificant decrease (fitting line slope = -0.4, t-test value p > 0.05). In the ERP-based brain network analysis, the neurofeedback group's network parameters were attenuated in all scales significantly (t-test value: p < 0.01); while the non-feedback group's most network parameters didn't change significantly (t-test value: p > 0.05).ConclusionThe MI-BCI training's short-term effects does not show up in the ERD analysis significantly but can be detected by ERP-based network analysis significantly. Results inspire the efficient evaluation of short-term rehabilitation training and provide a useful reference for subsequent studies.

Dataset Information

BCI system with lower-limb robot improves rehabilitation in spinal cord injury patients through short-term training: a pilot study.

Supplementary information

Publications

BCI system with lower-limb robot improves rehabilitation in spinal cord injury patients through short-term training: a pilot study.

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