Active Physical Practice Followed by Men a Practice Using BCI-Driven Hand Exoskeleton: A Pilot Trial for Clinical Effectiveness and Usability
Active Physical Practice Followed by Men a Practice Using BCI-Driven Hand Exoskeleton: A Pilot Trial for Clinical Effectiveness and Usability
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DOI：
10.1109/jbhi.2018.2863212
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发表时间：
2018-11-01
影响因子：
7.7
通讯作者：
Prasad, Girijesh
中科院分区：
文献类型：
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作者：
Chowdhury, Anirban;Meena, Yogesh Kumar;Prasad, Girijesh
在脑卒中后康复中，适当地结合心理练习（MP）和身体练习（PP）对于确保实质上积极的康复结果至关重要。在这里，我们提出了一个康复方案，包括一个单独的主动PP阶段，然后MP阶段，使用手外骨骼和脑机接口（BCI）。PP阶段介导的力传感器反馈为基础的辅助按需控制策略，而MP阶段提供BCI为基础的多模态神经反馈相结合的拟人视觉反馈和本体感觉反馈受损的手伸展尝试。对4名左手残疾的轻偏瘫中风患者（从16名患者中筛选出）进行了为期6周的临床试验。主要结果，运动功能恢复，测量的变化，握力（GS）和行动研究手臂测试（ARAT）分数，而次要结果，可用性的系统，测量的变化，情绪，疲劳和动机的视觉模拟量表。由于GS和ARAT相对于基线的组平均变化分别为+6.38 kg和+5.66 kg，因此发现了积极的康复结局。与基线相比，VAS量表测量结果还显示情绪改善（-1.38）、动力增加（+2.10）和疲劳减轻（-0.98）。因此，建议的神经康复协议被认为是有前途的临床有效性和可用性。
Appropriately combining mental practice (MP) and physical practice (PP) in a poststroke rehabilitation is critical for ensuring a substantially positive rehabilitation outcome. Here, we present a rehabilitation protocol incorporating a separate active PP stage followed by MP stage, using a hand exoskeleton and brain-computer interface (BCI). The PP stage was mediated by a force sensor feedback-based assist-as-needed control strategy, whereas the MP stage provided BCI-based multimodal neurofeed-back combining anthropomorphic visual feedback and proprioceptive feedback of the impaired hand extension attempt. A six week long clinical trial was conducted on four hemiparetic stroke patients (screened out of 16) with a left-hand disability. The primary outcome, motor functional recovery, was measured in terms of changes in grip-strength (GS) and action research arm test (ARAT) scores; whereas the secondary outcome, usability of the system was measured in terms of changes in mood, fatigue, and motivation on a visual-analog-scale. A positive rehabilitative outcome was found as the group mean changes from the baseline in the GS and ARAT were +6.38 kg and +5.66 accordingly. The VAS scale measurements also showed betterment in mood (-1.38), increased motivation (+2.10) and reduced fatigue (-0.98) as compared to the baseline. Thus, the proposed neurorehabilitation protocol is found to be promising both in terms of clinical effectiveness and usability.