# Motor imagery combined with brain-computer interface for stroke patients: a meta-analysis

## TL;DR

This study reviews how combining motor imagery with brain-computer interfaces affects stroke recovery, finding it helps daily living skills and motor function when used with traditional therapy.

## Contribution

The study provides a meta-analysis on the effectiveness of MI-BCI in stroke rehabilitation, highlighting context-dependent outcomes.

## Key findings

- MI-BCI showed moderate improvement in daily living activities for stroke patients.
- Upper limb motor function improved when MI-BCI was used alongside conventional therapy.
- A 4-week intervention duration is needed for significant functional gains.

## Abstract

To systematically evaluate the effects of motor imagery combined with brain-computer interface (MI-BCI) on stroke patients.

Randomized controlled trials (RCTs) on MI-BCI for stroke patients were retrieved from CNKI, Wanfang, VIP, CBM, PubMed, Cochrane Library, Embase, and Web of Science databases from inception to June 2025. Data were analyzed using RevMan 5.2 software.

Eight RCTs involving 357 stroke patients were included. The meta-analysis showed that MI-BCI was associated with an improvement in upper limb motor function, although this did not reach conventional statistical significance (SMD = 0.86, 95% CI = −0.04 to 1.75, p = 0.06). In contrast, a statistically significant, moderate-to-large improvement was found in activities of daily living (SMD = 1.47, 95% CI = 0.51 to 2.44, p = 0.003). Subgroup analyses indicated that the efficacy in motor function was primarily evident when MI-BCI was administered as an adjunct to conventional rehabilitation or with an intervention duration of ≥4 weeks.

The efficacy of MI-BCI is contingent upon its therapeutic context. When used as an adjunct to conventional rehabilitation, MI-BCI can significantly improve both upper limb motor function and activities of daily living in stroke patients. However, current evidence does not support its superiority over motor imagery alone when applied as a standalone therapy. An intervention duration of ≥4 weeks is recommended to achieve significant functional gains.