200 Section - Effect of BCI and Ankle Robot Training on Post-Stroke Motor Rehabilitation and Neuroplasticity

To assess BCI-controlled ankle robot training on post-stroke lower-limb motor recovery and neuroplasticity using quantitative EEG (qEEG).


Design: Thirty-two stroke patients were randomized to BCI (n=16, 40-min BCI-robot training) or control (n=16, 40-min ankle-robot training) groups, receiving 5 sessions/week for 2 weeks. Outcomes included Fugl-Meyer Assessment-Lower Extremity (FMA-LE), Berg Balance Scale (BBS), Functional Ambulatory Category (FAC), Modified Ashworth Scale (MAS), active range of motion (AROM), and muscle strength. QEEG assessed the relative power of the delta (rδ), theta (rθ), alpha (rα), beta (rβ) bands, spectral power ratios, pairwise-derived Brain Symmetry Index (pdBSI), and functional connectivity.

Results:

Both groups showed significant within-group improvements in dorsiflexion AROM, dorsiflexor strength, FMA-LE, BBS, and FAC (P < 0.05). The BCI group demonstrated significantly greater FMA-LE improvement than controls (P = 0.007) and reduced calf spasticity (MAS; P = 0.038). QEEG analysis in the BCI group revealed decreased rδ (P = 0.005), increased rα (P = 0.017), reduced DAR and DTABR (P < 0.05), reduced interhemispheric asymmetry (pdBSI-δ; P = 0.018), and enhanced Cz-parietal connectivity in α and β bands (P < 0.05).


Conclusion: BCI-controlled ankle robot training significantly improved lower-limb motor function and reduced spasticity post-stroke. Associated neurophysiological changes, characterized by reduced slow-wave power and asymmetry, increased alpha power and functional connectivity, indicated beneficial neuroplastic reorganization.