At-Home Stroke Neurorehabilitation: Early Findings with the NeuroExo BCI System

Background: Democratized access to safe and effective robotic neurorehabilitation for stroke survivors requires innovative, affordable solutions that can be used not only in clinics but also at home. This requires the high usability of the devices involved to minimize costs associated with support f...

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Main Authors: Juan José González-España, Lianne Sánchez-Rodríguez, Maxine Annel Pacheco-Ramírez, Jeff Feng, Kathryn Nedley, Shuo-Hsiu Chang, Gerard E. Francisco, Jose L. Contreras-Vidal
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Language:English
Published: MDPI AG 2025-02-01
Series:Sensors
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Online Access:https://www.mdpi.com/1424-8220/25/5/1322
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author Juan José González-España
Lianne Sánchez-Rodríguez
Maxine Annel Pacheco-Ramírez
Jeff Feng
Kathryn Nedley
Shuo-Hsiu Chang
Gerard E. Francisco
Jose L. Contreras-Vidal
author_facet Juan José González-España
Lianne Sánchez-Rodríguez
Maxine Annel Pacheco-Ramírez
Jeff Feng
Kathryn Nedley
Shuo-Hsiu Chang
Gerard E. Francisco
Jose L. Contreras-Vidal
author_sort Juan José González-España
collection DOAJ
description Background: Democratized access to safe and effective robotic neurorehabilitation for stroke survivors requires innovative, affordable solutions that can be used not only in clinics but also at home. This requires the high usability of the devices involved to minimize costs associated with support from physical therapists or technicians. Methods: This paper describes the early findings of the NeuroExo brain–machine interface (BMI) with an upper-limb robotic exoskeleton for stroke neurorehabilitation. This early feasibility study consisted of a six-week protocol, with an initial training and BMI calibration phase at the clinic followed by 60 sessions of neuromotor therapy at the homes of the participants. Pre- and post-assessments were used to assess users’ compliance and system performance. Results: Participants achieved a compliance rate between <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mn>21</mn><mo>%</mo></mrow></semantics></math></inline-formula> and <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mn>100</mn><mo>%</mo></mrow></semantics></math></inline-formula>, with an average of <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mn>69</mn><mo>%</mo></mrow></semantics></math></inline-formula>, while maintaining adequate signal quality and a positive perceived BMI performance during home usage with an average Likert scale score of four out of five. Moreover, adequate signal quality was maintained for four out of five participants throughout the protocol. These findings provide valuable insights into essential components for comprehensive rehabilitation therapy for stroke survivors. Furthermore, linear mixed-effects statistical models showed a significant reduction in trial duration (<i>p</i>-value < 0.02) and concomitant changes in brain patterns (<i>p</i>-value < 0.02). Conclusions: the analysis of these findings suggests that a low-cost, safe, simple-to-use BMI system for at-home stroke rehabilitation is feasible.
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spelling doaj-art-7fded45d7e68449a8dacea8b1f9dff362025-08-20T02:59:01ZengMDPI AGSensors1424-82202025-02-01255132210.3390/s25051322At-Home Stroke Neurorehabilitation: Early Findings with the NeuroExo BCI SystemJuan José González-España0Lianne Sánchez-Rodríguez1Maxine Annel Pacheco-Ramírez2Jeff Feng3Kathryn Nedley4Shuo-Hsiu Chang5Gerard E. Francisco6Jose L. Contreras-Vidal7Department of Electrical and Computer Engineering, University of Houston, Houston, TX 77004, USADepartment of Electrical and Computer Engineering, University of Houston, Houston, TX 77004, USADepartment of Electrical and Computer Engineering, University of Houston, Houston, TX 77004, USANoninvasive Brain-Machine Interface Systems Laboratory, NSF Industry—University Cooperative Research Center for Building Reliable Advances and Innovations in Neurotechnology (IUCRC BRAIN) Center, University of Houston, Houston, TX 77004, USADepartment of Physical Medicine & Rehabilitation, University of Texas Health McGovern Medical School, Houston, TX 77030, USADepartment of Physical Medicine & Rehabilitation, University of Texas Health McGovern Medical School, Houston, TX 77030, USADepartment of Physical Medicine & Rehabilitation, University of Texas Health McGovern Medical School, Houston, TX 77030, USADepartment of Electrical and Computer Engineering, University of Houston, Houston, TX 77004, USABackground: Democratized access to safe and effective robotic neurorehabilitation for stroke survivors requires innovative, affordable solutions that can be used not only in clinics but also at home. This requires the high usability of the devices involved to minimize costs associated with support from physical therapists or technicians. Methods: This paper describes the early findings of the NeuroExo brain–machine interface (BMI) with an upper-limb robotic exoskeleton for stroke neurorehabilitation. This early feasibility study consisted of a six-week protocol, with an initial training and BMI calibration phase at the clinic followed by 60 sessions of neuromotor therapy at the homes of the participants. Pre- and post-assessments were used to assess users’ compliance and system performance. Results: Participants achieved a compliance rate between <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mn>21</mn><mo>%</mo></mrow></semantics></math></inline-formula> and <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mn>100</mn><mo>%</mo></mrow></semantics></math></inline-formula>, with an average of <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mn>69</mn><mo>%</mo></mrow></semantics></math></inline-formula>, while maintaining adequate signal quality and a positive perceived BMI performance during home usage with an average Likert scale score of four out of five. Moreover, adequate signal quality was maintained for four out of five participants throughout the protocol. These findings provide valuable insights into essential components for comprehensive rehabilitation therapy for stroke survivors. Furthermore, linear mixed-effects statistical models showed a significant reduction in trial duration (<i>p</i>-value < 0.02) and concomitant changes in brain patterns (<i>p</i>-value < 0.02). Conclusions: the analysis of these findings suggests that a low-cost, safe, simple-to-use BMI system for at-home stroke rehabilitation is feasible.https://www.mdpi.com/1424-8220/25/5/1322brain–computer interfaceselectroencephalographystroke rehabilitationmovement intent detectionhome therapywearables
spellingShingle Juan José González-España
Lianne Sánchez-Rodríguez
Maxine Annel Pacheco-Ramírez
Jeff Feng
Kathryn Nedley
Shuo-Hsiu Chang
Gerard E. Francisco
Jose L. Contreras-Vidal
At-Home Stroke Neurorehabilitation: Early Findings with the NeuroExo BCI System
Sensors
brain–computer interfaces
electroencephalography
stroke rehabilitation
movement intent detection
home therapy
wearables
title At-Home Stroke Neurorehabilitation: Early Findings with the NeuroExo BCI System
title_full At-Home Stroke Neurorehabilitation: Early Findings with the NeuroExo BCI System
title_fullStr At-Home Stroke Neurorehabilitation: Early Findings with the NeuroExo BCI System
title_full_unstemmed At-Home Stroke Neurorehabilitation: Early Findings with the NeuroExo BCI System
title_short At-Home Stroke Neurorehabilitation: Early Findings with the NeuroExo BCI System
title_sort at home stroke neurorehabilitation early findings with the neuroexo bci system
topic brain–computer interfaces
electroencephalography
stroke rehabilitation
movement intent detection
home therapy
wearables
url https://www.mdpi.com/1424-8220/25/5/1322
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