On the Way Home: a BCI-FES hand therapy self-managed by sub-acute SCI participants and their caregivers: a usability study

Zulauf-Czaja, A., Al-taleb, M. K.H., Purcell, M., Petric-Gray, N., Cloughley, J. and Vuckovic, A. (2021) On the Way Home: a BCI-FES hand therapy self-managed by sub-acute SCI participants and their caregivers: a usability study. Journal of NeuroEngineering and Rehabilitation, 18, 44. (doi: 10.1186/s12984-021-00838-y) (PMID:33632262) (PMCID:PMC7905902)

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Abstract

Background: Regaining hand function is the top priority for people with tetraplegia, however access to specialised therapy outwith clinics is limited. Here we present a system for hand therapy based on brain-computer interface (BCI) which uses a consumer grade electroencephalography (EEG) device combined with functional electrical stimulation (FES), and evaluate its usability among occupational therapists (OTs) and people with spinal cord injury (SCI) and their family members. Methods: Users: Eight people with sub-acute SCI (6 M, 2F, age 55.4 ± 15.6) and their caregivers (3 M, 5F, age 45.3 ± 14.3); four OTs (4F, age 42.3 ± 9.8). User Activity: Researchers trained OTs; OTs subsequently taught caregivers to set up the system for the people with SCI to perform hand therapy. Hand therapy consisted of attempted movement (AM) of one hand to lower the power of EEG sensory-motor rhythm in the 8-12 Hz band and thereby activate FES which induced wrist flexion and extension. Technology: Consumer grade wearable EEG, multichannel FES, custom made BCI application. Location: Research space within hospital. Evaluation: donning times, BCI accuracy, BCI and FES parameter repeatability, questionnaires, focus groups and interviews. Results: Effectiveness: The BCI accuracy was 70–90%. Efficiency: Median donning times decreased from 40.5 min for initial session to 27 min during last training session (N = 7), dropping to 14 min on the last self-managed session (N = 3). BCI and FES parameters were stable from session to session. Satisfaction: Mean satisfaction with the system among SCI users and caregivers was 3.68 ± 0.81 (max 5) as measured by QUEST questionnaire. Main facilitators for implementing BCI-FES technology were “seeing hand moving”, “doing something useful for the loved ones”, good level of computer literacy (people with SCI and caregivers), “active engagement in therapy” (OT), while main barriers were technical complexity of setup (all groups) and “lack of clinical evidence” (OT). Conclusion: BCI-FES has potential to be used as at home hand therapy by people with SCI or stroke, provided it is easy to use and support is provided. Transfer of knowledge of operating BCI is possible from researchers to therapists to users and caregivers.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Petric-Gray, Miss Nina and Al-taleb, Manaf Kadum Hussein and Purcell, Mariel and Zulauf-Czaja, ANNA and Vuckovic, Dr Aleksandra
Authors: Zulauf-Czaja, A., Al-taleb, M. K.H., Purcell, M., Petric-Gray, N., Cloughley, J., and Vuckovic, A.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
College of Science and Engineering
College of Science and Engineering > School of Engineering
College of Science and Engineering > School of Engineering > Biomedical Engineering
Journal Name:Journal of NeuroEngineering and Rehabilitation
Publisher:BMC
ISSN:1743-0003
ISSN (Online):1743-0003
Published Online:25 February 2021
Copyright Holders:Copyright © The Author(s) 2021
First Published:First published in Journal of NeuroEngineering and Rehabilitation 18:44
Publisher Policy:Reproduced under a Creative Commons license

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
172865EPSRC DTP 16/17 and 17/18Tania GalabovaEngineering and Physical Sciences Research Council (EPSRC)EP/N509668/1Research and Innovation Services
190790EPSRC DTG 2014Mary Beth KneafseyEngineering and Physical Sciences Research Council (EPSRC)EP/M506539/1Research and Innovation Services