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Brain-Machine Interface With Virtual Reality and Neuromuscular Electrical Stimulation for Upper Limb Rehabilitation After Stroke
Sponsor: Marta Sofia Ramos Torres
Summary
Stroke is a major cause of long-term disability, and many stroke survivors experience persistent difficulties moving and using their affected arm and hand. Improving upper limb function is an important goal of stroke rehabilitation. This study aims to investigate whether adding brain-machine interface (BMI) training to conventional rehabilitation improves upper limb motor recovery after stroke. The BMI system uses electroencephalography (EEG) to detect brain activity associated with imagined or attempted hand movements and provides visual feedback through virtual reality (VR). Neuromuscular electrical stimulation (NMES) is also applied to the affected wrist and finger extensor muscles during designated movement tasks. A total of 68 adults undergoing inpatient rehabilitation after ischemic stroke will be randomly assigned to one of two groups. Both groups will receive standard rehabilitation. The experimental group will additionally receive BMI training with VR feedback and NMES, while the control group will receive NMES without BMI or VR feedback. Both groups will complete 12 additional sessions over four weeks. The main outcome will be the change in upper limb motor impairment, assessed using the Fugl-Meyer Assessment for the Upper Extremity (FM-UE). Other measures will assess upper limb activity, muscle strength, and functional independence. The study will help determine whether BMI-assisted training provides additional benefits compared with NMES alone when combined with conventional inpatient stroke rehabilitation.
Official title: Post-Stroke Upper Limb Motor Rehabilitation Using a Brain-Machine Interface With Virtual Reality-Based Neurofeedback: Study Protocol for a Randomized Controlled Trial
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
68
Start Date
2026-12
Completion Date
2028-05
Last Updated
2026-11-02
Healthy Volunteers
No
Conditions
Interventions
Brain-Machine Interface Training With Virtual Reality and NMES
Participants will undergo 12 sessions over four weeks (three sessions per week) of EEG-based brain-machine interface (BMI) training combined with immersive virtual reality (VR) neurofeedback and neuromuscular electrical stimulation (NMES). Participants will perform kinesthetic motor imagery or attempted movements of the affected wrist and fingers. EEG-based classification will provide real-time visual neurofeedback. NMES will be delivered to the affected wrist and finger extensors during designated movement cues, independently of EEG classifier output. Each session includes calibration and real-time feedback training, with 40 electrical stimulations.
Neuromuscular Electrical Stimulation
Participants will receive 12 sessions over four weeks (three sessions per week) of neuromuscular electrical stimulation (NMES) targeting the affected wrist and finger extensors. Each session will include 40 electrical stimulations delivered at regular intervals over approximately 20 minutes. Stimulation parameters will match those used in the experimental group. No brain-machine interface training, virtual reality neurofeedback, or structured motor imagery will be provided.
Locations (1)
Centro de Reabilitação do Norte (CRN), Unidade Local de Saúde de Gaia e Espinho
Vila Nova de Gaia, Porto District, Portugal