500 Section - Is Brain-Computer Interface Ready to Aid Rehabilitation? Engineering Advances and Clinical Applications in adult and peadiatric stroke

Objectives : To evaluate the potential of brain-computer interfaces (BCIs), particularly when combined with functional electrical stimulation (FES), as effective tools in neurorehabilitation for individuals with motor impairments due to perinatal, childhood, or adult stroke.

Design: This work reviews engineering advancements and clinical applications of BCI technology, with a focus on BCI-FES integration. It includes findings from multiple studies, including a pilot study conducted by the presenter involving 13 children with cerebral palsy secondary to perinatal stroke, as well as other pediatric and adult post-stroke trials. The presenter brings a unique perspective as a PM&R resident with an engineering background and over 8 years of experience in developing and clinically testing BCI systems.

Results: BCI-FES systems have demonstrated safety, comfort, and usability in children with cerebral palsy. The pilot study showed that children were able to successfully engage with the system. Additional pediatric trials reported enhanced motor control and engagement through BCI-based therapy. In adults recovering from stroke, randomized controlled trials suggest that BCI-FES therapy, particularly in the subacute phase, leads to improved upper limb function. However, challenges such as device usability, inter-subject variability, and long-term efficacy persist.

Conclusion: BCI-FES technology shows promise as a tool for promoting neuroplasticity and improving functional outcomes in neurorehabilitation. While clinical and engineering progress is encouraging, further work is needed to address usability and consistency before BCI systems can be widely adopted into standard rehabilitation practice.