Abstract—Current rehabilitation therapies for stroke rely on Physical Practice (PP) by the patients. Motor Imagery (MI), the imagination of movements without physical action, presents an alternate neuro-rehabilitation for stroke patients without relying

Current rehabilitation therapies for stroke rely on Physical Practice (PP) by the patients. Motor Imagery (MI), the imagination of movements without physical action, presents an alternate neuro-rehabilitation for stroke patients without relying on residue movements. However, MI is an endogenous mental process that is not physically observable. Recently, advances in Brain-Computer Interface (BCI) technology have enabled the objective detection of MI that spearheaded this alternate neurorehabilitation for stroke. In this review, we present 2 strategies of using BCI for neuro-rehabilitation after stroke: detecting MI to trigger a feedback, and detecting MI with a robot to provide concomitant MI and PP. We also present 3 randomized control trials (RCTs) that employed these 2 strategies for upper limb rehabilitation. A total of 125 chronic stroke patients were screened over 6 years. The BCI screening revealed that 103 (82%) patients can use EEG-based BCI, and 75 (60%) performed well with accuracies above 70%. A total of 67 patients were recruited to complete one of the 3 RCTs ranging from 2 to 6 weeks of which 26 patients, who underwent BCI neurorehabilitation that employed these 2 strategies, had significant motor improvement of 4.5 measured by Fugl-Meyer Motor Assessment of the upper extremity. Hence the results demonstrate clinical efficacy of using BCI as an alternate neurorehabilitation for stroke.