Development of an Application That Implements a Brain–Computer Interface to an Upper-Limb Motor Assistance Robot to Facilitate Active Exercise in Patients: A Feasibility Study

Abstract

In this study, we aimed to evaluate the effectiveness of a brain robot in rehabilitation that combines motor imagery (MI), robotic motor assistance, and electrical stimulation. Thirteen in-patients with severe post-stroke hemiplegia underwent electroencephalography (EEG), measured according to the international 10–20 method, during MI. The dicephalus robotic system (DiC) was activated by detecting event-related desynchronization (ERD) using the Markov switching model (MSM) and relative power (RP) from the EEG of the motor cortex (C3 and C4). The reaction times (the time between ERD detection and DiC activation) of the MSM and RP were compared using Wilcoxon’s signed rank sum test. ERD was detected in all 13 and 12 patients with the MSM and RP, respectively. The DiC reaction time for the ERD detection process was significantly shorter for the MSM (13.02 ± 0.16 s) than for the RP (19.95 ± 7.45 s) (W = 9, p = 0.0037). The results of this study suggest that ERD responses can be detected in the motor cortex during MI in patients with severe upper-extremity paralysis; the MSM is more effective than the RP in detecting ERD when the EEG signal is used as a switch to activate the robot, and the reaction time to detect the signal is shorter.