A systematic review of the effects of brain-computer interface on lower limb motor function, balance function, and activities of daily living in stroke patients

TL;DR

This study reviews how brain-computer interfaces help stroke patients with leg movement, balance, and daily tasks.

Contribution

The paper provides a systematic review and meta-analysis of BCI effects on stroke recovery outcomes.

Findings

BCI significantly improves lower limb motor function and daily living activities in stroke patients.

BCI interventions during acute/subacute phases and with higher doses show better outcomes.

Balance function improvements from BCI were not statistically significant.

Abstract

To systematically evaluate the effects of brain-computer interface (BCI) technology on lower limb motor function, balance function, and activities of daily living in stroke patients.

This study followed the PRISMA guidelines and searched PubMed, Web of Science, EMbase, The Cochrane Library, CNKI, Wanfang, and VIP databases, with an additional manual search. The search period was from database inception to March 2024. The PEDro scale was used to assess the quality of the studies, the GRADE system was applied to evaluate the evidence quality for outcome measures, and Meta-analysis was conducted using Stata 17.0 software.

The systematic review included nine studies. The methodological quality, assessed using the PEDro scale, yielded an average score of 6.9, which corresponds to a moderate-to-low certainty of evidence. The Meta-analysis showed that BCI technology significantly improved lower limb motor function (MD = 3.52, 95% CI [2.03, 5.00], p < 0.001) and activities of daily living (MD = 6.08, 95% CI [1.81, 10.35], p = 0.01), but had no significant effect on balance function (MD = 4.82, 95% CI [−1.53, 11.16], p = 0.14). Subgroup analysis showed that the effect size in the acute and subacute phases was 3.89, and in the recovery phase, it was 3.12, both of which were statistically significant. In terms of intervention methods, the effect size for MI-BCI was 2.73, and for BCI-Robot, it was 4.60, both statistically significant. Regarding intervention dosage, the effect size for 2.5–10 h was 2.60, and for 12–20 h, it was 5.46, both statistically significant.

Current evidence suggests that BCI-based interventions have a beneficial effect on lower limb motor function and activities of daily living in stroke patients. Interventions initiated during the acute or subacute phase, with a total dose exceeding 12 h, appear to be associated with superior outcomes. However, the certainty of this evidence is moderate to low, necessitating further validation. Future research should prioritize large-scale, high-quality randomized controlled trials to definitively establish the efficacy of BCI technology and elucidate its optimal implementation protocols.

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