Rehabilitation of hand in subacute tetraplegic patients based on brain computer interface and functional electrical stimulation: a randomised pilot study
Objective. To compare neurological and functional outcomes between two groups of hospitalised
patients with subacute tetraplegia. Approach. Seven patients received 20 sessions of brain
computer interface (BCI) controlled functional electrical stimulation (FES) while five patients
received the same number of sessions of passive FES for both hands. The neurological
assessment measures were event related desynchronization (ERD) during movement attempt,
Somatosensory evoked potential (SSEP) of the ulnar and median nerve; assessment of hand
function involved the range of motion (ROM) of wrist and manual muscle test. Main results.
Patients in both groups initially had intense ERD during movement attempt that was not
restricted to the sensory-motor cortex. Following the treatment, ERD cortical activity restored
towards the activity in able-bodied people in BCI-FES group only, remaining wide-spread in
FES group. Likewise, SSEP returned in 3 patients in BCI-FES group, having no changes in FES
group. The ROM of the wrist improved in both groups. Muscle strength significantly improved
for both hands in BCI-FES group. For FES group, a significant improvement was noticed for
right hand flexor muscles only. Significance. Combined BCI-FES therapy results in better
neurological recovery and better improvement of muscle strength than FES alone. For spinal
cord injured patients, BCI-FES should be considered as a therapeutic tool rather than solely a
long-term assistive device for the restoration of a lost function
