Brain-computer interface-based robotic end effector system for wrist and hand rehabilitation: results of a three-armed randomized controlled trial for chronic stroke.
Brain-computer interface-based robotic end effector system for wrist and hand rehabilitation: results of a three-armed randomized controlled trial for chronic stroke.
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DOI：
10.3389/fneng.2014.00030
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Chua KS
中科院分区：
文献类型：
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作者：
Ang KK;Guan C;Phua KS;Wang C;Zhou L;Tang KY;Ephraim Joseph GJ;Kuah CW;Chua KS
本研究的目的是探讨基于脑电图（EEG）的运动想象（MI）脑-机接口（BCI）与触觉旋钮（HK）机器人耦合用于中风患者手臂康复的有效性。在这项三组、单盲、随机对照试验中，21例慢性偏瘫卒中患者（Fugl-Meyer运动评估（FMMA）评分10-50）在MI BCI能力预筛选后招募，随机分配至BCI-HK、HK或标准臂治疗（SAT）组。两组均接受为期6周的18次干预，每周3次，每次90 min。BCI-HK组接受1 h BCI + HK干预，HK组接受1 h HK干预。BCI-HK和HK组均接受了120次机器人辅助手抓握和旋钮操作试验，然后进行30分钟的治疗师辅助手臂活动。SAT组接受1.5小时的治疗师辅助手臂活动和前臂旋前-旋后运动，包括腕部控制和抓握-释放功能。共招募了14名男性，7名女性，平均年龄54.2岁，平均卒中持续时间385.1天，基线FMMA评分27.0。主要结局指标为第3周干预中期、第6周干预结束时以及第12周和第24周随访时测量的上肢FMMA评分。分别有7例、8例和7例受试者接受了BCI-HK、HK和SAT干预。所有组的FMMA评分均有所改善，但在任何时间点均未发现组间差异。在第3、12和24周，与SAT组相比，在BCI-HK组中观察到显著更大的运动增益，但在任何时间点，HK组的运动增益与SAT组没有差异。总之，BCI-HK是有效的，安全的，并可能有潜力提高运动恢复慢性中风时，治疗师辅助手臂活动。
The objective of this study was to investigate the efficacy of an Electroencephalography (EEG)-based Motor Imagery (MI) Brain-Computer Interface (BCI) coupled with a Haptic Knob (HK) robot for arm rehabilitation in stroke patients. In this three-arm, single-blind, randomized controlled trial; 21 chronic hemiplegic stroke patients (Fugl-Meyer Motor Assessment (FMMA) score 10–50), recruited after pre-screening for MI BCI ability, were randomly allocated to BCI-HK, HK or Standard Arm Therapy (SAT) groups. All groups received 18 sessions of intervention over 6 weeks, 3 sessions per week, 90 min per session. The BCI-HK group received 1 h of BCI coupled with HK intervention, and the HK group received 1 h of HK intervention per session. Both BCI-HK and HK groups received 120 trials of robot-assisted hand grasping and knob manipulation followed by 30 min of therapist-assisted arm mobilization. The SAT group received 1.5 h of therapist-assisted arm mobilization and forearm pronation-supination movements incorporating wrist control and grasp-release functions. In all, 14 males, 7 females, mean age 54.2 years, mean stroke duration 385.1 days, with baseline FMMA score 27.0 were recruited. The primary outcome measure was upper extremity FMMA scores measured mid-intervention at week 3, end-intervention at week 6, and follow-up at weeks 12 and 24. Seven, 8 and 7 subjects underwent BCI-HK, HK and SAT interventions respectively. FMMA score improved in all groups, but no intergroup differences were found at any time points. Significantly larger motor gains were observed in the BCI-HK group compared to the SAT group at weeks 3, 12, and 24, but motor gains in the HK group did not differ from the SAT group at any time point. In conclusion, BCI-HK is effective, safe, and may have the potential for enhancing motor recovery in chronic stroke when combined with therapist-assisted arm mobilization.