Brain–Computer Interfaces: Neurorehabilitation of Voluntary Movement after Stroke and Spinal Cord Injury

Description

Stroke and spinal cord injury often result in paralysis with serious negative consequences to the independence and quality of life of those who sustain them. For these individuals, rehabilitation provides the means to regain lost function. Rehabilitation following neurological injuries has undergone revolutionary changes, enriched by neuroplasticity. Neuroplastic-based interventions enhance the efficacy and continue to guide the development of new rehabilitation strategies. This book presents three important technology-based rehabilitation interventions that follow the concepts of neuroplasticity. The book also discusses clinical results related to their efficacy. These interventions are: functional electrical stimulation therapy, which produces coordinated muscle contractions allowing people with paralysis to perform functional movements with rich sensory feedback; robot-assisted therapy, which uses robots to assist, resist, and guide movements with increased intensity while also reducing the physical burden on therapists; and brain–computer interfaces, which make it possible to verify the presence of motor-related brain activity during rehabilitation. Further, the book presents the combined use of these three technologies to illustrate some of the emerging approaches to the neurorehabilitation of voluntary movement. The authors share their practical experiences obtained during the development and clinical testing of functional electrical stimulation therapy controlled by a brain–computer interface as an intervention to restore reaching and grasping. Acknowledgments Stroke, Spinal Cord Injury, and Neurorehabilitation 1.1 Stroke 1.1.1 Definition and Epidemiology 1.1.2 Types, Pathophysiology, and Clinical Presentation 1.2 Spinal Cord Injury 1.2.1 Definition and Epidemiology 1.2.2 Types of SCI, Pathophysiology, and Clinical Presentation 1.3 Rehabilitation Following Stroke and Spinal Cord Injury 1.4 Neuroplasticity and Neuroplasticity-Based Interventions 1.4.1 Functional Electrical Stimulation Therapy 1.4.2 Robot-Assisted Therapy 1.5 Challenges in Rehabilitation of Voluntary Movement After Stroke and SCI Functional Electrical Stimulation Therapy: A Closer Look 2.1 History of Functional Electrical Stimulation Therapy (FEST) 2.2 Transcutaneous FES system 2.2.1 FES Hardware 2.2.2 FES Software 2.3 Rehabilitation in Stroke and Use of FEST 2.3.1 Lower Limb Function in Stroke and Role of FEST 2.3.2 Upper Limb Function in Stroke and Role of FEST 2.4 Rehabilitation After Spinal Cord Injury (SCI) and Use of FEST 2.4.1 Lower Limb Function in Spinal Cord Injury and Role of FEST 2.4.2 Upper Limb Function in Spinal Cord Injury and Role of FEST 2.5 Our Experiences with Surface FEST to Restore Upper Extremity Function after Stroke and Spinal Cord Injury 2.6 Limitations and Contraindications for Surface FEST Application Robotic-Assisted Rehabilitation 3.1 End-Effector Robots 3.1.1 End Effector Upper Extremity Robots 3.1.2 End Effector Lower Extremity Robots 3.2 Exoskeletons 3.2.1 Upper Extremity Exoskeletons 3.2.2 Lower Extremity Exoskeletons 3.3 Current State of Evidence: Robotic-Assisted Therapy 3.3.1 Robotic-Assisted Rehabilitation after Stroke 3.3.2 Robotic-Assisted Rehabilitation after Spinal Cord Injury 3.4 Robotic and FES Hybrid Systems 3.4.1 Robotic—FES Hybrid Systems for Walking 3.4.2 Hybrid Systems with Joint-Breaking 3.4.3 Hybrid Systems with Active Joint Control 3.4.4 Robotic—FES Hybrid Systems for Upper Limb Function 3.5 Closing Statement Brain–computer Interfaces 4.1 Definition 4.2 Components of a BCI 4.2.1 Signals for Implementing BCI Systems 4.2.2 Non-Invasive Recordings 4.3 Other Classifications of BCI Systems 4.3.1 Endogenous vs. Exogenous 4.3.2 Synchronous vs. Asynchronous BCI Systems 4.4 Converting Brain Activity into a Control Signal 4.5 Motor-Related EEG Features for BCI Implementation 4.5.1 Even-Related Desynchronization (ERD) 4.5.2 Motor-Related Cortical Potential (MRCP) 4.6 Applications of BCI Technologies 4.6.1 Augmentative Communication 4.6.2 Computer Access 4.6.3 Additional Demonstration Applications 4.6.4 Facilitation of Movement After Paralysis The Intersection of Brain–computer Interfaces and Neurorehabilitation 5.1 The Interconnection Between BCI Technology and Neurorehabilitation 5.1.1 Motor Imagery 5.2 Approaches to Integration of BCI Technology into Neurorehabilitation 5.2.1 BCI as an Adjuvant to Therapy 5.2.2 BCI for Triggering Voluntary Movement During Rehabilitation 5.3 Motor Restoration After Stroke Using BCI Technology 5.3.1 Upper Limb Function 5.3.2 Lower Limb Function 5.4 Motor Restoration After Spinal Cord Injury Using BCI-Technology 5.4.1 Upper Limb Function 5.4.2 Lower Limb Function Implementation of a BCI-Triggered Functional Electrical Stimulation Therapy 6.1 Introduction 6.2 Enhancing FEST with BCI Technology 6.2.1 General Description of the System Design 6.2.2 Implementation 6.2.3 Operation 6.2.4 Clinical Testing Concluding Remarks 7.1 Final Thoughts 7.2 A Reflection on the Status to Date 7.3 What the Future May Bring 7.4 The Role of BCI Technology in Neurorehabilitation 7.4.1 Combination of Interventions 7.4.2 Feedback Device for Treating Clinician 7.4.3 Rehabilitation of Other Conditions 7.5 Recommended Reading References Authors’ Biographies Blank Page