THE USE OF A COMPLEX “BRAIN-COMPUTER INTERFACE AND EXO-SKELETON” AND MOVEMENT IMAGINATION TECHNIQUE FOR POST-STROKE REHABILITATION

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Abstract

Background: Efficacy of physical exercise and movement imagination for restoration of motor dysfunction after a stroke is seen as proven. However, the use of movement imagination is complicated by impossibility of objective and subjective control over  the exercise, as well as by the absence of their motor support. The brain-computer interface based on electroencephalography is a technique that enables a feedback during movement imagination.

Materials and methods: We assessed 10 patients (6 men and 4 women) aged from 30 to 66 years (mean age, 47 ± 7.7 years) with an ischemic (n = 9) and hemorrhagic (n = 1) stroke during the last 2 months to 4 years. Online recognition of movement imagination was done by a classifier with a brain computer interface. An exo-skeleton supported passive movements in a paretic hand managed by the brain-computer interface. During 2 weeks the patients had 10 sessions of 45–90 minute duration each. For control, we used data from 5 stroke patients who, in addition to their standard treatment, underwent an imitation of rehabilitation procedures without movement imagination and feedback. To assess efficacy of treatment, we used a modified Ashworth scale, Fugl-Meyer scale, test for evaluation of hand functions ARAT, British scale for assessment of muscle force MRC-SS. Level of everyday activity and working ability was measured with a modified Rankin scale and Bartel index. Cognitive functions were assessed with Schulte tables.

Results: Online recognition of movement imagination according to desynchronization of μ rhythm was registered in 50–75% of patients. All patients reported a subjective improvement of motor functions and working ability. Positive results for at least one parameter were observed in all patients; however, there were no significant difference between the parameters before and after rehabilitation procedures, excluding cognitive functions (degree of warming-up, p < 0.02).

Conclusion: In post stroke patients, the use of movement imagination, brain-computer interface and exo-skeleton does not seem to affect the rehabilitation process negatively. In all cases, some positive results were achieved in motor recovery, as well as in working ability and daily activity. The results of the rehabilitation procedure are promising; however, the study should be continued.

About the authors

S. V. Kotov

Moscow Regional Research and Clinical Institute (MONIKI)

Author for correspondence.
Email: kotovsv@yandex.ru

MD, PhD, Professor; Head of Department of Neurology; Head of Chair of Neurology, Postgraduate Training Faculty

Russian Federation

L. G. Turbina

Moscow Regional Research and Clinical Institute (MONIKI)

Email: fake@neicon.ru

MD, PhD, Professor; Chair of Neurology, Postgraduate Training Faculty

Russian Federation

P. D. Bobrov

Institute of Higher Nervous Activity and Neurophysiology of Russian Academy of Sciences

Email: fake@neicon.ru

PhD, Research Fellow, Mathematical Neurobiology of Learning Laboratory

Russian Federation

A. A. Frolov

Institute of Higher Nervous Activity and Neurophysiology of Russian Academy of Sciences

Email: fake@neicon.ru

PhD, ScD in Biology, Professor; Head of Mathematical Neurobiology of Learning Laboratory

Russian Federation

O. G. Pavlova

Institute of Higher Nervous Activity and Neurophysiology of Russian Academy of Sciences

Email: fake@neicon.ru

PhD, Senior Research Fellow, Mathematical Neurobiology of Learning Laboratory

Russian Federation

M. E. Kurganskaya

Institute of Higher Nervous Activity and Neurophysiology of Russian Academy of Sciences

Email: fake@neicon.ru

PhD, Research Fellow, Mathematical Neurobiology of Learning Laboratory

Russian Federation

E. V. Biryukova

Institute of Higher Nervous Activity and Neurophysiology of Russian Academy of Sciences, Pirogov Russian National Research Medical University

Email: fake@neicon.ru

PhD, Senior Research Fellow, Mathematical Neurobiology of Learning Laboratory

Russian Federation

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Copyright (c) 2015 Kotov S.V., Turbina L.G., Bobrov P.D., Frolov A.A., Pavlova O.G., Kurganskaya M.E., Biryukova E.V.

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This work is licensed under a Creative Commons Attribution 4.0 International License.

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