Application of Brain-Computer Interactive Rehabilitation Training Combined With a Gait Robot: A Randomized Controlled Trial.

OBJECTIVE

To explore the effects of brain-computer interactive (BCI) rehabilitation training combined with gait robot (GR) on gait recovery in patients with hemiplegia after stroke.

DESIGN

Randomized controlled trial.

SETTING

Hospital settings across the Shandong Provincial Third Hospital.

PARTICIPANTS

A total of 120 eligible subjects were enrolled and randomly allocated, via random-number table, into 4 equal groups (n=30 each): control (routine training), BCI, GR, and BCI-GR (BCI combined with GR training).

INTERVENTIONS: Each group received its designated training once daily, 6 d/wk, for 8 consecutive weeks.

MAIN OUTCOME MEASURES: Fugl-Meyer Assessment-Lower Extremity (FMA-LE), Berg Balance Scale (BBS), Functional Ambulation Category (FAC), integrated electromyography (IEMG), and stride parameters. Assessments were conducted at baseline, 4 wk, and 8 wk.

RESULTS

After 8 wk, all interventions-BCI, GR, and BCI-GR-significantly improved lower-limb function, muscle activity, and gait compared with control (all P<.01). FMA-LE increased by +12.93 (BCI-GR), +12.16 (BCI), and +12.07 (GR) versus +8.20 in control; BBS improved by +14.53, +13.63, and +14.30 versus +9.53; FAC improved by +1.73, +1.73, and +1.77 versus +1.37. IEMG of tibialis anterior and gastrocnemius increased most in BCI-GR (+0.156 and +0.063), significantly higher than BCI and GR (P<.05), whereas co-contraction ratio decreased most in BCI-GR (-18.59%; P<.05). Stride parameters (step frequency, step length, step width, and walking speed) improved in all intervention groups, with BCI-GR showing greater gains in step frequency (+25.90) and step width reduction (-12.87) versus single interventions (P<.05). No other significant differences among intervention groups were observed at week 8.

CONCLUSIONS

BCI and GR interventions significantly improve lower-limb motor function, muscle activation, and gait in poststroke patients. Combined BCI-GR training accelerates early functional recovery and more effectively enhances muscle activation patterns compared with single interventions, providing a promising strategy for poststroke rehabilitation.