Brain-computer interface combined with mental practice and occupational therapy enhances upper limb motor recovery, activities of daily living, and participation in subacute stroke.

Autor:	Zanona AF; Department of Occupational Therapy and Graduate Program in Applied Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil., Piscitelli D; School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.; Department of Kinesiology, University of Connecticut, Storrs, CT, United States., Seixas VM; Department of Occupational Therapy and Graduate Program in Applied Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil., Scipioni KRDDS; Department of Occupational Therapy, Federal University of Paraná, Curitiba, Paraná, Brazil., Bastos MSC; Department of Occupational Therapy, Federal University of Paraná, Curitiba, Paraná, Brazil., de Sá LCK; Department of Occupational Therapy, Federal University of Paraná, Curitiba, Paraná, Brazil., Monte-Silva K; Department of Physical Therapy, Federal University of Pernambuco, Recife, Pernambuco, Brazil., Bolivar M; Department of Occupational Therapy and Graduate Program in Applied Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil., Solnik S; Department of Physical Therapy, University of North Georgia, Dahlonega, GA, United States.; Department of Physical Education, Wroclaw University of Health and Sport Sciences, Wroclaw, Poland., De Souza RF; Department of Occupational Therapy and Graduate Program in Applied Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil.
Jazyk:	angličtina
Zdroj:	Frontiers in neurology [Front Neurol] 2023 Jan 09; Vol. 13, pp. 1041978. Date of Electronic Publication: 2023 Jan 09 (Print Publication: 2022).
DOI:	10.3389/fneur.2022.1041978
Abstrakt:	Background: We investigated the effects of brain-computer interface (BCI) combined with mental practice (MP) and occupational therapy (OT) on performance in activities of daily living (ADL) in stroke survivors. Methods: Participants were randomized into two groups: experimental ( n = 23, BCI controlling a hand exoskeleton combined with MP and OT) and control ( n = 21, OT). Subjects were assessed with the functional independence measure (FIM), motor activity log (MAL), amount of use (MAL-AOM), and quality of movement (MAL-QOM). The box and blocks test (BBT) and the Jebsen hand functional test (JHFT) were used for the primary outcome of performance in ADL, while the Fugl-Meyer Assessment was used for the secondary outcome. Exoskeleton activation and the degree of motor imagery (measured as event-related desynchronization) were assessed in the experimental group. For the BCI, the EEG electrodes were placed on the regions of FC3, C3, CP3, FC4, C4, and CP4, according to the international 10-20 EEG system. The exoskeleton was placed on the affected hand. MP was based on functional tasks. OT consisted of ADL training, muscle mobilization, reaching tasks, manipulation and prehension, mirror therapy, and high-frequency therapeutic vibration. The protocol lasted 1 h, five times a week, for 2 weeks. Results: There was a difference between baseline and post-intervention analysis for the experimental group in all evaluations: FIM ( p = 0.001, d = 0.56), MAL-AOM ( p = 0.001, d = 0.83), MAL-QOM ( p = 0.006, d = 0.84), BBT ( p = 0.004, d = 0.40), and JHFT ( p = 0.001, d = 0.45). Within the experimental group, post-intervention improvements were detected in the degree of motor imagery ( p < 0.001) and the amount of exoskeleton activations ( p < 0.001). For the control group, differences were detected for MAL-AOM ( p = 0.001, d = 0.72), MAL-QOM ( p = 0.013, d = 0.50), and BBT ( p = 0.005, d = 0.23). Notably, the effect sizes were larger for the experimental group. No differences were detected between groups at post-intervention. Conclusion: BCI combined with MP and OT is a promising tool for promoting sensorimotor recovery of the upper limb and functional independence in subacute post-stroke survivors. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2023 Zanona, Piscitelli, Seixas, Scipioni, Bastos, de Sá, Monte-Silva, Bolivar, Solnik and De Souza.)
Databáze:	MEDLINE
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