BCI-FES for Upper Limb Rehabilitation in Chronic Stroke

The intervention involves a BCI control strategy based on a modified version of the classic P300 Donchin Speller Interface, where the matrix of letters and symbols is replaced by a set of pictures including five hand gestures and wrist orientations: hand opening, grasping, pinching, pronation, and supination. This BCI approach is based on the oddball paradigm, relying on conscious recognition by the user of the intensification of a particular target movement picture, within a sequence of other, non-target, random visual stimuli. This process should evoke the P300 component in the event related potential. The aim of the training sessions is to link an action observation/target selection task, mediated by the P300-based BCI, with the practice of a FES-assisted functional task involving the target movement picture selected. Users will be instructed to synchronize their voluntary movements with the ones induced by FES, to achieve the functional target goal.

Conventional physical and occupational therapy will include sessions of joint mobility, muscle strength, task-specific training, sensitivity reeducation and coordination exercises directed by an experienced professional therapist.