A Single-Session Preliminary Evaluation of an Affordable BCI-Controlled Arm Exoskeleton and Motor-Proprioception Platform

Traditional, hospital-based stroke rehabilitation can be labor-intensive and expensive. Furthermore, outcomes from rehabilitation are inconsistent across individuals and recovery is hard to predict. Given these uncertainties, numerous technological approaches have been tested in an effort to improve rehabilitation outcomes and reduce the cost of stroke rehabilitation. These techniques include brain-computer interface (BCI), robotic exoskeletons, functional electrical stimulation (FES), and proprioceptive feedback. However, to the best of our knowledge, no studies have combined all these approaches into a rehabilitation platform that facilitates goal-directed motor movements. Therefore, in this paper, we combined all these technologies to test the feasibility of using a BCI-driven exoskeleton with FES (robotic training device) to facilitate motor task completion among individuals with stroke. The robotic training device operated to assist a pre-defined goal-directed motor task. Because it is hard to predict who can utilize this type of technology, we considered whether the ability to adapt skilled movements with proprioceptive feedback would predict who could learn to control a BCI-driven robotic device. To accomplish this aim, we developed a motor task that requires proprioception for completion to assess motor-proprioception ability. Next, we tested the feasibility of robotic training system in individuals with chronic stroke (n = 9) and found that the training device was well tolerated by all the participants. Ability on the motor-proprioception task did not predict the time to completion of the BCI-driven task. Both participants who could accurately target (n = 6) and those who could not (n = 3), were able to learn to control the BCI device, with each BCI trial lasting on average 2.47 min. Our results showed that the participants' ability to use proprioception to control motor output did not affect their ability to use the BCI-driven exoskeleton with FES. Based on our preliminary results, we show that our robotic training device has potential for use as therapy for a broad range of individuals with stroke.