International Journal of Physical Medicine & Rehabilitation
Open Access

Abstract

Hemiparetic Stroke Rehabilitation Using Avatar and Electrical Stimulation Based on Non-invasive Brain Computer Interface

Woosang Cho, Alexander Heilinger, Ren Xu, Manuela Zehetner, Stefan Schobesberger, Nensi Murovec, Rupert Ortner and Christoph Guger

Brain computer interfaces (BCIs) have been employed in rehabilitation training for post-stroke patients. Patients in the chronic stage, and/or with severe paresis, are particularly challenging for conventional rehabilitation. We present results from two such patients who participated in BCI training with first-person avatar feedback. Five assessments were conducted to assess any behavioural changes after the intervention, including the upper extremity Fugl-Meyer assessment (UE-FMA) and 9 hole-peg test (9HPT). Patient 1 (P1) increased his UE-FMA score from 25 to 46 points after the intervention. He could not perform the 9HPT in the first session. After the 18th session, he was able to perform the 9HPT and reduced the time from 10 min 22 sec to 2 min 53 sec. Patient 2 (P2) increased her UE-FMA from 17 to 28 points after the intervention. She could not perform the 9HPT throughout the training session. However, she managed to complete the test in 17 min 17 sec during the post-assessment session. These results show that the feasibility of this BCI approach with chronic patients with severe paresis, and further support the growing consensus that these types of tools might develop into a new paradigm for rehabilitation tool for stroke patients. However, the results are from only two chronic stroke patients. This approach should be further validated in broader randomized controlled studies involving more patients.