Active Physical Practice Followed by Mental Practice Using BCI-Driven Hand Exoskeleton: A Pilot Trial for Clinical Effectiveness and Usability

Anirban Chowdhury, Yogesh Kumar Meena, Raza Haider, Braj Bhushan, Ashwani Kumar Uttam, Nirmal Pandey, Adnan Ariz Hashmi, Alok Bajpai, Ashish Dutta, Girijesh Prasad

Research output: Contribution to journalArticle

13 Citations (Scopus)
39 Downloads (Pure)

Abstract

Appropriately combining mental practice (MP) and physical practice (PP) in a post-stroke rehabilitation is critical for ensuring a substantially positive rehabilitation outcome. Here we present a rehabilitation protocol incorporating a separate active PP stage followed by MP stage, using a hand exoskeleton and brain-computer interface (BCI). The PP stage was mediated by a force sensor feedback based assist-as-needed control strategy, whereas the MP stage provided BCI based multimodal neurofeedback combining anthropomorphic visual feedback and proprioceptive feedback of the impaired hand extension attempt. A 6 week long clinical trial was conducted on 4 hemiparetic stroke patients (screened out of 16) with left hand disability. The primary outcome, motor functional recovery, was measured in terms of changes in Grip-Strength (GS) and Action Research Arm Test (ARAT) scores; whereas the secondary outcome, usability of the system, was measured in terms of changes in mood, fatigue and motivation on a visual-analog-scale (VAS). A positive rehabilitative outcome was found as the group mean changes from the baseline in the GS and ARAT were +6.38 kg and +5.66 accordingly. The VAS scale measurements also showed betterment in mood (-1.38), increased motivation (+2.10) and reduced fatigue (-0.98) as compared to the baseline. Thus the proposed neurorehabilitation protocol is found to be promising both in terms of clinical effectiveness and usability.
Original languageEnglish
Pages (from-to)1786-1795
Number of pages9
JournalIEEE Journal of Biomedical and Health Informatics
Volume22
Issue number6
Early online date3 Aug 2018
DOIs
Publication statusE-pub ahead of print - 3 Aug 2018

Keywords

  • Exoskeletons
  • visualisation
  • Usability
  • informatics
  • Neurofeedback
  • Clinical trials
  • BCI
  • EEG
  • Neurohabilitation
  • Stroke

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