Post-stroke Rehabilitation of Severe Upper Limb Paresis in Germany – Toward Long-Term Treatment With Brain-Computer Interfaces

Severe upper limb paresis can represent an immense burden for stroke survivors. Given the rising prevalence of stroke, restoration of severe upper limb motor impairment remains a major challenge for rehabilitation medicine because effective treatment strategies are lacking. Commonly applied interven...

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Autores principales:	Cornelius Angerhöfer, Annalisa Colucci, Mareike Vermehren, Volker Hömberg, Surjo R. Soekadar
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	brain-computer interface severe upper limb paresis neurorehabilitation long-term treatment neurotechnology Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/a73e3ea221c94b7babf9e49b41087674
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spelling	oai:doaj.org-article:a73e3ea221c94b7babf9e49b410876742021-11-18T08:54:45ZPost-stroke Rehabilitation of Severe Upper Limb Paresis in Germany – Toward Long-Term Treatment With Brain-Computer Interfaces1664-229510.3389/fneur.2021.772199https://doaj.org/article/a73e3ea221c94b7babf9e49b410876742021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fneur.2021.772199/fullhttps://doaj.org/toc/1664-2295Severe upper limb paresis can represent an immense burden for stroke survivors. Given the rising prevalence of stroke, restoration of severe upper limb motor impairment remains a major challenge for rehabilitation medicine because effective treatment strategies are lacking. Commonly applied interventions in Germany, such as mirror therapy and impairment-oriented training, are limited in efficacy, demanding for new strategies to be found. By translating brain signals into control commands of external devices, brain-computer interfaces (BCIs) and brain-machine interfaces (BMIs) represent promising, neurotechnology-based alternatives for stroke patients with highly restricted arm and hand function. In this mini-review, we outline perspectives on how BCI-based therapy can be integrated into the different stages of neurorehabilitation in Germany to meet a long-term treatment approach: We found that it is most appropriate to start therapy with BCI-based neurofeedback immediately after early rehabilitation. BCI-driven functional electrical stimulation (FES) and BMI robotic therapy are well suited for subsequent post hospital curative treatment in the subacute stage. BCI-based hand exoskeleton training can be continued within outpatient occupational therapy to further improve hand function and address motivational issues in chronic stroke patients. Once the rehabilitation potential is exhausted, BCI technology can be used to drive assistive devices to compensate for impaired function. However, there are several challenges yet to overcome before such long-term treatment strategies can be implemented within broad clinical application: 1. developing reliable BCI systems with better usability; 2. conducting more research to improve BCI training paradigms and 3. establishing reliable methods to identify suitable patients.Cornelius AngerhöferAnnalisa ColucciMareike VermehrenVolker HömbergSurjo R. SoekadarFrontiers Media S.A.articlebrain-computer interfacesevere upper limb paresisneurorehabilitationlong-term treatmentneurotechnologyNeurology. Diseases of the nervous systemRC346-429ENFrontiers in Neurology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	brain-computer interface severe upper limb paresis neurorehabilitation long-term treatment neurotechnology Neurology. Diseases of the nervous system RC346-429
spellingShingle	brain-computer interface severe upper limb paresis neurorehabilitation long-term treatment neurotechnology Neurology. Diseases of the nervous system RC346-429 Cornelius Angerhöfer Annalisa Colucci Mareike Vermehren Volker Hömberg Surjo R. Soekadar Post-stroke Rehabilitation of Severe Upper Limb Paresis in Germany – Toward Long-Term Treatment With Brain-Computer Interfaces
description	Severe upper limb paresis can represent an immense burden for stroke survivors. Given the rising prevalence of stroke, restoration of severe upper limb motor impairment remains a major challenge for rehabilitation medicine because effective treatment strategies are lacking. Commonly applied interventions in Germany, such as mirror therapy and impairment-oriented training, are limited in efficacy, demanding for new strategies to be found. By translating brain signals into control commands of external devices, brain-computer interfaces (BCIs) and brain-machine interfaces (BMIs) represent promising, neurotechnology-based alternatives for stroke patients with highly restricted arm and hand function. In this mini-review, we outline perspectives on how BCI-based therapy can be integrated into the different stages of neurorehabilitation in Germany to meet a long-term treatment approach: We found that it is most appropriate to start therapy with BCI-based neurofeedback immediately after early rehabilitation. BCI-driven functional electrical stimulation (FES) and BMI robotic therapy are well suited for subsequent post hospital curative treatment in the subacute stage. BCI-based hand exoskeleton training can be continued within outpatient occupational therapy to further improve hand function and address motivational issues in chronic stroke patients. Once the rehabilitation potential is exhausted, BCI technology can be used to drive assistive devices to compensate for impaired function. However, there are several challenges yet to overcome before such long-term treatment strategies can be implemented within broad clinical application: 1. developing reliable BCI systems with better usability; 2. conducting more research to improve BCI training paradigms and 3. establishing reliable methods to identify suitable patients.
format	article
author	Cornelius Angerhöfer Annalisa Colucci Mareike Vermehren Volker Hömberg Surjo R. Soekadar
author_facet	Cornelius Angerhöfer Annalisa Colucci Mareike Vermehren Volker Hömberg Surjo R. Soekadar
author_sort	Cornelius Angerhöfer
title	Post-stroke Rehabilitation of Severe Upper Limb Paresis in Germany – Toward Long-Term Treatment With Brain-Computer Interfaces
title_short	Post-stroke Rehabilitation of Severe Upper Limb Paresis in Germany – Toward Long-Term Treatment With Brain-Computer Interfaces
title_full	Post-stroke Rehabilitation of Severe Upper Limb Paresis in Germany – Toward Long-Term Treatment With Brain-Computer Interfaces
title_fullStr	Post-stroke Rehabilitation of Severe Upper Limb Paresis in Germany – Toward Long-Term Treatment With Brain-Computer Interfaces
title_full_unstemmed	Post-stroke Rehabilitation of Severe Upper Limb Paresis in Germany – Toward Long-Term Treatment With Brain-Computer Interfaces
title_sort	post-stroke rehabilitation of severe upper limb paresis in germany – toward long-term treatment with brain-computer interfaces
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/a73e3ea221c94b7babf9e49b41087674
work_keys_str_mv	AT corneliusangerhofer poststrokerehabilitationofsevereupperlimbparesisingermanytowardlongtermtreatmentwithbraincomputerinterfaces AT annalisacolucci poststrokerehabilitationofsevereupperlimbparesisingermanytowardlongtermtreatmentwithbraincomputerinterfaces AT mareikevermehren poststrokerehabilitationofsevereupperlimbparesisingermanytowardlongtermtreatmentwithbraincomputerinterfaces AT volkerhomberg poststrokerehabilitationofsevereupperlimbparesisingermanytowardlongtermtreatmentwithbraincomputerinterfaces AT surjorsoekadar poststrokerehabilitationofsevereupperlimbparesisingermanytowardlongtermtreatmentwithbraincomputerinterfaces
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Post-stroke Rehabilitation of Severe Upper Limb Paresis in Germany – Toward Long-Term Treatment With Brain-Computer Interfaces

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