Proposed Topic (Most preferred): :
Clinical Safety and Quality Service I (Projects aiming to improve efficiency and effectiveness of care delivery to meet international standards)
Proposed Topic (Second preferred): :
Research and Innovations (new projects / technology / innovations / service models)
Authors (including presenting author) :
Lau KY(1), Chan WC(1), Sun LY(1), Lam CY(1), Ho CC(1), Ng HM(1), Wong CY(1), Luk SH(1), Chan CH(1), Chan CL(1), Chan KH(1)
Affiliation :
(1)Physiotherapy Department, Haven of Hope Hospital
Introduction :
Stroke is a common cause leading to disability in Hong Kong. Rehabilitation in stroke survivors with severe upper extremity hemiparesis is often challenging. BCI-FES intervention is one of the novel treatment approaches in stroke rehabilitation. It is a motor imagery (MI) based BCI system, which translates brain activity through electroencephalogram (EEG) signals and activate FES as a closed-loop sensorimotor feedback for motor rehabilitation. Virtual Reality (VR) system is used to facilitate MI.
Objectives :
To evaluate the effectiveness of the BCI-FES in enhancing upper limb functions in stroke survivors.
Methodology :
One-group pretest-posttest design was adopted. 15 stroke patients were recruited in our hospital from October 2022 to March 2024. Patients with cognitive impairment or intolerant prolonged sitting were excluded. On top of conventional rehabilitation program, BCI-FES intervention was provided to these patients. Each patient received two to three one-hour training sessions per week for three to four weeks. During the BCI-FES training, patients were instructed to imagine extending either left or right wrist randomly. MI based BCI system analyzed the EEG signal while patients were performing MI. FES was activated to stimulate the wrist extensors when the EEG signal reached a preset threshold. The outcome measures were (1) Active Range of Motion (AROM); (2) Muscle power (by Oxford Scale); (3) Modified Ashworth Scale (MAS) of elbow flexors and extensors; (4) Power grip and (5) Motricity index of the paretic upper limb.
Result & Outcome :
Results: Each subject received 14 treatment sessions on average. Significant improvement were shown in outcomes (mean difference; 95%CI) including AROM of shoulder flexion (19.67°; 6.20°-33.13°), shoulder abduction (11.61°; 1.11°-22.22°) and elbow flexion (30.33°; 8.92°-51.74°), power grip (2.75kgF; 1.36kgF-4.15kgF) and Motricity index (8.87; 3.06-14.67). Median muscle power of elbow extensors and wrist extensors both significantly improved from grade 1 to 2 in Oxford Scale. All p values <0.05. No significant difference was found in MAS. No adverse event was reported. Conclusion: BCI-FES intervention shows positive effect on upper limb recovery in stroke survivors. It can be considered as a treatment adjunct for severe upper extremity hemiparesis.
