Restoration of Upper Limb Function After Chronic Severe Hemiplegia: A Case Report on the Feasibility of a Brain-Computer Interface-Triggered Functional Electrical Stimulation Therapy.

Abstract

Functional electrical stimulation therapy (FEST) is a state-of-the-art treatment for retraining motor function after neurological injuries. Recent literature suggests that FEST can be further improved with brain-computer interface (BCI) technology. In this case study, we assessed the feasibility of using BCI-triggered FEST (BCI-FEST) to restore upper limb function in a 57-yr-old man with severe left hemiplegia resulting from a stroke 6 yrs before enrollment in the study. The intervention consisted of two blocks of forty 1-hr BCI-FEST sessions, with three sessions delivered weekly. During therapy, a single-channel BCI was used to trigger the stimulation programmed to facilitate functional movements. The measure of the feasibility of the BCI-FEST included assessing the implementation and safety of the intervention. Clinical improvements were assessed using (a) Functional Independence Measure, (b) Action Research Arm Test, (c) Toronto Rehabilitation Institute - Hand Function Test, and (d) Fugl-Meyer Assessment Upper Extremity test. Upon completion of 80 therapy sessions, 14-, 17-, and 18-point changes were recorded on Action Research Arm Test, Fugl-Meyer Assessment Upper Extremity test, and Toronto Rehabilitation Institute - Hand Function Test, respectively. The participant also indicated improvement as demonstrated by his ability to perform various day-to-day tasks. The results suggest that BCI-FEST is safe and viable.

• Authors: Lazar I Jovanovic, Naaz Kapadia, Lorna Lo, Vera Zivanovic, Milos R Popovic, Cesar Marquez-Chin
• Journal: American journal of physical medicine & rehabilitation (Am J Phys Med Rehabil) Vol. 99 Issue 3 Pg. e35-e40 (03 2020) ISSN: 1537-7385 [Electronic] United States
• PMID: 30768447 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Brain-Computer Interfaces
• Electric Stimulation Therapy
• Feasibility Studies
• Hemiplegia (physiopathology, rehabilitation)
• Humans
• Male
• Middle Aged
• Recovery of Function
• Stroke Rehabilitation (methods)
• Upper Extremity (physiopathology)