On the way home: a BCI‑FES hand therapy self‑managed by sub‑acute SCI participants and their caregivers: a usability study

J NeuroEngineering Rehabil, 2021 · DOI: https://doi.org/10.1186/s12984-021-00838-y · Published: January 1, 2021

Spinal Cord Injury Neurology Neurorehabilitation

Simple Explanation

This study explores the feasibility of using a brain-computer interface (BCI) combined with functional electrical stimulation (FES) for hand therapy at home for individuals with spinal cord injury (SCI). The system uses a consumer-grade EEG device and aims to transfer knowledge of operating the BCI from researchers to therapists, and then to users and caregivers. The BCI system allows users to attempt hand movements, which, when detected by the EEG, trigger FES to stimulate wrist flexion and extension. This aims to provide a accessible hand therapy solution outside of specialized clinics. The study evaluates the usability of the system in terms of efficiency, effectiveness, and satisfaction among therapists, SCI patients, and their caregivers, identifying potential barriers and facilitators for adopting this technology at home.

Study Duration

Not specified

Participants

8 people with sub-acute SCI, their caregivers, and 4 OTs

Evidence Level

Not specified

Key Findings

1
The BCI accuracy was between 70 and 90%.
2
Median donning times decreased from 40.5 minutes to 14 minutes, indicating improved efficiency with practice.
3
Mean satisfaction with the system among SCI users and caregivers was 3.68 ± 0.81 (max 5), demonstrating moderate satisfaction.

Research Summary

The study investigated the feasibility of a BCI-FES system for at-home hand therapy, focusing on the transfer of knowledge from researchers to therapists, caregivers, and SCI patients. The system uses consumer-grade EEG technology and FES to assist hand movement. Results showed that OTs could effectively train caregivers to operate the system. SCI users and caregivers reported moderate satisfaction, with perceived usefulness and ease of use being key factors. Donning times improved with practice. Barriers to adoption included the time-consuming nature of setup, technical complexity, and the need for user-friendly interfaces. Facilitators included the caregivers' willingness to help and the visual feedback of hand movement.

Practical Implications

Home-Based Therapy Potential

BCI-FES systems show promise for delivering hand therapy at home, especially for those in rural areas with limited access to specialized clinics.

Importance of User-Centered Design

Future development should prioritize user-friendliness, minimize setup time, and integrate the device into activities of daily living to improve adherence.

Role of Caregivers

Engaging caregivers in the therapy process can increase motivation and support for SCI patients, enhancing the potential for successful at-home rehabilitation.

Study Limitations

1
Small number of participants limits the generalizability of the findings.
2
Short intervention period prevents definitive conclusions about the therapy's effectiveness.
3
Study took place in a research space, which may not fully represent the challenges of a home environment.

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