Rehabilitation of hand in subacute tetraplegic patients based on brain computer interface and functional electrical stimulation: a randomised pilot study

摘要

Objective. To compare neurological and functional outcomes between two groups of hospitalisedudpatients with subacute tetraplegia. Approach. Seven patients received 20 sessions of brainudcomputer interface (BCI) controlled functional electrical stimulation (FES) while five patientsudreceived the same number of sessions of passive FES for both hands. The neurologicaludassessment measures were event related desynchronization (ERD) during movement attempt,udSomatosensory evoked potential (SSEP) of the ulnar and median nerve; assessment of handudfunction involved the range of motion (ROM) of wrist and manual muscle test. Main results.udPatients in both groups initially had intense ERD during movement attempt that was notudrestricted to the sensory-motor cortex. Following the treatment, ERD cortical activity restoredudtowards the activity in able-bodied people in BCI-FES group only, remaining wide-spread inudFES group. Likewise, SSEP returned in 3 patients in BCI-FES group, having no changes in FESudgroup. The ROM of the wrist improved in both groups. Muscle strength significantly improvedudfor both hands in BCI-FES group. For FES group, a significant improvement was noticed forudright hand flexor muscles only. Significance. Combined BCI-FES therapy results in betterudneurological recovery and better improvement of muscle strength than FES alone. For spinaludcord injured patients, BCI-FES should be considered as a therapeutic tool rather than solely audlong-term assistive device for the restoration of a lost function.