A hybrid brain-muscle-machine interface for stroke rehabilitation: Usability and functionality validation in a 2-week intensive intervention
Introduction: The primary constraint of non-invasive brain-machine interfaces (BMIs) in stroke rehabilitation lies in the poor spatial resolution of motor intention related neural activity capture. To address this limitation, hybrid brain-muscle-machine interfaces (hBMIs) have been suggested as supe...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-04-01
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| Series: | Frontiers in Bioengineering and Biotechnology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fbioe.2024.1330330/full |
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| author | Andrea Sarasola-Sanz Andreas M. Ray Ainhoa Insausti-Delgado Nerea Irastorza-Landa Wala Jaser Mahmoud Doris Brötz Carlos Bibián-Nogueras Florian Helmhold Christoph Zrenner Christoph Zrenner Christoph Zrenner Christoph Zrenner Christoph Zrenner Ulf Ziemann Ulf Ziemann Eduardo López-Larraz Ander Ramos-Murguialday Ander Ramos-Murguialday |
| author_facet | Andrea Sarasola-Sanz Andreas M. Ray Ainhoa Insausti-Delgado Nerea Irastorza-Landa Wala Jaser Mahmoud Doris Brötz Carlos Bibián-Nogueras Florian Helmhold Christoph Zrenner Christoph Zrenner Christoph Zrenner Christoph Zrenner Christoph Zrenner Ulf Ziemann Ulf Ziemann Eduardo López-Larraz Ander Ramos-Murguialday Ander Ramos-Murguialday |
| author_sort | Andrea Sarasola-Sanz |
| collection | DOAJ |
| description | Introduction: The primary constraint of non-invasive brain-machine interfaces (BMIs) in stroke rehabilitation lies in the poor spatial resolution of motor intention related neural activity capture. To address this limitation, hybrid brain-muscle-machine interfaces (hBMIs) have been suggested as superior alternatives. These hybrid interfaces incorporate supplementary input data from muscle signals to enhance the accuracy, smoothness and dexterity of rehabilitation device control. Nevertheless, determining the distribution of control between the brain and muscles is a complex task, particularly when applied to exoskeletons with multiple degrees of freedom (DoFs). Here we present a feasibility, usability and functionality study of a bio-inspired hybrid brain-muscle machine interface to continuously control an upper limb exoskeleton with 7 DoFs.Methods: The system implements a hierarchical control strategy that follows the biologically natural motor command pathway from the brain to the muscles. Additionally, it employs an innovative mirror myoelectric decoder, offering patients a reference model to assist them in relearning healthy muscle activation patterns during training. Furthermore, the multi-DoF exoskeleton enables the practice of coordinated arm and hand movements, which may facilitate the early use of the affected arm in daily life activities. In this pilot trial six chronic and severely paralyzed patients controlled the multi-DoF exoskeleton using their brain and muscle activity. The intervention consisted of 2 weeks of hBMI training of functional tasks with the system followed by physiotherapy. Patients’ feedback was collected during and after the trial by means of several feedback questionnaires. Assessment sessions comprised clinical scales and neurophysiological measurements, conducted prior to, immediately following the intervention, and at a 2-week follow-up.Results: Patients’ feedback indicates a great adoption of the technology and their confidence in its rehabilitation potential. Half of the patients showed improvements in their arm function and 83% improved their hand function. Furthermore, we found improved patterns of muscle activation as well as increased motor evoked potentials after the intervention.Discussion: This underscores the significant potential of bio-inspired interfaces that engage the entire nervous system, spanning from the brain to the muscles, for the rehabilitation of stroke patients, even those who are severely paralyzed and in the chronic phase. |
| first_indexed | 2024-04-24T10:52:10Z |
| format | Article |
| id | doaj.art-7becc8bab7d64b9f98c4e5d0e9ac2e16 |
| institution | Directory Open Access Journal |
| issn | 2296-4185 |
| language | English |
| last_indexed | 2024-04-24T10:52:10Z |
| publishDate | 2024-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Bioengineering and Biotechnology |
| spelling | doaj.art-7becc8bab7d64b9f98c4e5d0e9ac2e162024-04-12T11:00:03ZengFrontiers Media S.A.Frontiers in Bioengineering and Biotechnology2296-41852024-04-011210.3389/fbioe.2024.13303301330330A hybrid brain-muscle-machine interface for stroke rehabilitation: Usability and functionality validation in a 2-week intensive interventionAndrea Sarasola-Sanz0Andreas M. Ray1Ainhoa Insausti-Delgado2Nerea Irastorza-Landa3Wala Jaser Mahmoud4Doris Brötz5Carlos Bibián-Nogueras6Florian Helmhold7Christoph Zrenner8Christoph Zrenner9Christoph Zrenner10Christoph Zrenner11Christoph Zrenner12Ulf Ziemann13Ulf Ziemann14Eduardo López-Larraz15Ander Ramos-Murguialday16Ander Ramos-Murguialday17Health Unit, TECNALIA, Basque Research and Technology Alliance (BRTA), San Sebastian, SpainInstitute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, GermanyHealth Unit, TECNALIA, Basque Research and Technology Alliance (BRTA), San Sebastian, SpainHealth Unit, TECNALIA, Basque Research and Technology Alliance (BRTA), San Sebastian, SpainInstitute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, GermanyInstitute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, GermanyInstitute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, GermanyInstitute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, GermanyDepartment of Neurology and Stroke, University Tübingen, Tübingen, GermanyHertie Institute for Clinical Brain Research, University Tübingen, Tübingen, GermanyTemerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, CanadaDepartment of Psychiatry, University of Toronto, Toronto, CanadaInstitute for Biomedical Engineering, University of Toronto, Toronto, CanadaDepartment of Neurology and Stroke, University Tübingen, Tübingen, GermanyHertie Institute for Clinical Brain Research, University Tübingen, Tübingen, GermanyBitbrain, Zaragoza, SpainHealth Unit, TECNALIA, Basque Research and Technology Alliance (BRTA), San Sebastian, SpainInstitute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, GermanyIntroduction: The primary constraint of non-invasive brain-machine interfaces (BMIs) in stroke rehabilitation lies in the poor spatial resolution of motor intention related neural activity capture. To address this limitation, hybrid brain-muscle-machine interfaces (hBMIs) have been suggested as superior alternatives. These hybrid interfaces incorporate supplementary input data from muscle signals to enhance the accuracy, smoothness and dexterity of rehabilitation device control. Nevertheless, determining the distribution of control between the brain and muscles is a complex task, particularly when applied to exoskeletons with multiple degrees of freedom (DoFs). Here we present a feasibility, usability and functionality study of a bio-inspired hybrid brain-muscle machine interface to continuously control an upper limb exoskeleton with 7 DoFs.Methods: The system implements a hierarchical control strategy that follows the biologically natural motor command pathway from the brain to the muscles. Additionally, it employs an innovative mirror myoelectric decoder, offering patients a reference model to assist them in relearning healthy muscle activation patterns during training. Furthermore, the multi-DoF exoskeleton enables the practice of coordinated arm and hand movements, which may facilitate the early use of the affected arm in daily life activities. In this pilot trial six chronic and severely paralyzed patients controlled the multi-DoF exoskeleton using their brain and muscle activity. The intervention consisted of 2 weeks of hBMI training of functional tasks with the system followed by physiotherapy. Patients’ feedback was collected during and after the trial by means of several feedback questionnaires. Assessment sessions comprised clinical scales and neurophysiological measurements, conducted prior to, immediately following the intervention, and at a 2-week follow-up.Results: Patients’ feedback indicates a great adoption of the technology and their confidence in its rehabilitation potential. Half of the patients showed improvements in their arm function and 83% improved their hand function. Furthermore, we found improved patterns of muscle activation as well as increased motor evoked potentials after the intervention.Discussion: This underscores the significant potential of bio-inspired interfaces that engage the entire nervous system, spanning from the brain to the muscles, for the rehabilitation of stroke patients, even those who are severely paralyzed and in the chronic phase.https://www.frontiersin.org/articles/10.3389/fbioe.2024.1330330/fullhybrid brain-muscle-machine interfacestrokeupper limb rehabilitationmultidegree of freedom exoskeletonbio-inspired motor controlcortico-muscular connection |
| spellingShingle | Andrea Sarasola-Sanz Andreas M. Ray Ainhoa Insausti-Delgado Nerea Irastorza-Landa Wala Jaser Mahmoud Doris Brötz Carlos Bibián-Nogueras Florian Helmhold Christoph Zrenner Christoph Zrenner Christoph Zrenner Christoph Zrenner Christoph Zrenner Ulf Ziemann Ulf Ziemann Eduardo López-Larraz Ander Ramos-Murguialday Ander Ramos-Murguialday A hybrid brain-muscle-machine interface for stroke rehabilitation: Usability and functionality validation in a 2-week intensive intervention Frontiers in Bioengineering and Biotechnology hybrid brain-muscle-machine interface stroke upper limb rehabilitation multidegree of freedom exoskeleton bio-inspired motor control cortico-muscular connection |
| title | A hybrid brain-muscle-machine interface for stroke rehabilitation: Usability and functionality validation in a 2-week intensive intervention |
| title_full | A hybrid brain-muscle-machine interface for stroke rehabilitation: Usability and functionality validation in a 2-week intensive intervention |
| title_fullStr | A hybrid brain-muscle-machine interface for stroke rehabilitation: Usability and functionality validation in a 2-week intensive intervention |
| title_full_unstemmed | A hybrid brain-muscle-machine interface for stroke rehabilitation: Usability and functionality validation in a 2-week intensive intervention |
| title_short | A hybrid brain-muscle-machine interface for stroke rehabilitation: Usability and functionality validation in a 2-week intensive intervention |
| title_sort | hybrid brain muscle machine interface for stroke rehabilitation usability and functionality validation in a 2 week intensive intervention |
| topic | hybrid brain-muscle-machine interface stroke upper limb rehabilitation multidegree of freedom exoskeleton bio-inspired motor control cortico-muscular connection |
| url | https://www.frontiersin.org/articles/10.3389/fbioe.2024.1330330/full |
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