Efficacy of Brain-Computer Interface and the Impact of Its Design Characteristics on Poststroke Upper-limb Rehabilitation: A Systematic Review and Meta-analysis of Randomized Controlled Trials
- PMID: 33913351
- PMCID: PMC8619716
- DOI: 10.1177/15500594211009065
Efficacy of Brain-Computer Interface and the Impact of Its Design Characteristics on Poststroke Upper-limb Rehabilitation: A Systematic Review and Meta-analysis of Randomized Controlled Trials
- PMID: 33913351
- PMCID: PMC8619716
- DOI: 10.1177/15500594211009065
Abstract
Background. A number of recent randomized controlled trials reported the efficacy of brain-computer interface (BCI) for upper-limb stroke rehabilitation compared with other therapies. Despite the encouraging results reported, there is a significant variance in the reported outcomes. This paper aims to investigate the effectiveness of different BCI designs on poststroke upper-limb rehabilitation. Methods. The effect sizes of pooled and individual studies were assessed by computing Hedge's g values with a 95% confidence interval. Subgroup analyses were also performed to examine the impact of different BCI designs on the treatment effect. Results. The study included 12 clinical trials involving 298 patients. The analysis showed that the BCI yielded significant superior short-term and long-term efficacy in improving the upper-limb motor function compared to the control therapies (Hedge's g = 0.73 and 0.33, respectively). Based on our subgroup analyses, the BCI studies that used the intention of movement had a higher effect size compared to those used motor imagery (Hedge's g = 1.21 and 0.55, respectively). The BCI studies using band power features had a significantly higher effect size than those using filter bank common spatial patterns features (Hedge's g = 1.25 and - 0.23, respectively). Finally, the studies that used functional electrical stimulation as the BCI feedback had the highest effect size compared to other devices (Hedge's g = 1.2). Conclusion. This meta-analysis confirmed the effectiveness of BCI for upper-limb rehabilitation. Our findings support the use of band power features, the intention of movement, and the functional electrical stimulation in future BCI designs for poststroke upper-limb rehabilitation.
Keywords: brain–computer interface; mental tasks; meta-analysis; randomized clinical trials; stroke rehabilitation.
Conflict of interest statement
Figures
Figure 1.
Components of brain–computer interface commonly…
Figure 1.
Components of brain–computer interface commonly used for upper-limb stroke rehabilitation.
Figure 2.
Preferred reporting items for systematic…
Figure 2.
Preferred reporting items for systematic reviews and meta-analyses (PRISMA) flowchart illustrating the process…
Figure 3.
Evaluating effects of brain–computer interface,…
Figure 3.
Evaluating effects of brain–computer interface, compared to control interventions, in improving upper-limb motor…
Figure 4.
(A) A subgroup meta-analysis comparing…
Figure 4.
(A) A subgroup meta-analysis comparing the efficacy of brain–computer interface in improving upper-limb…
Figure 5.
A subgroup meta-analysis comparing the…
Figure 5.
A subgroup meta-analysis comparing the efficacy of brain–computer interface, grouped based on different…
Figure 6.
A subgroup meta-analysis comparing the…
Figure 6.
A subgroup meta-analysis comparing the efficacy of brain–computer interface, grouped based on different…
References
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- Soekadar SR, Birbaumer N, Slutzky MW, Cohen LG. Brain–machine interfaces in neurorehabilitation of stroke. Neurobiol Dis. 2015;83:172–179. doi:10.1016/j.nbd.2014.11.025 - PubMed
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