TY - JOUR
T1 - Restoring activities of daily living using an EEG/EOG-controlled semiautonomous and mobile whole-arm exoskeleton in chronic stroke
AU - Nann, Marius
AU - Cordella, Francesca
AU - Trigili, Emilio
AU - Lauretti, Clemente
AU - Bravi, Marco
AU - Miccinilli, Sandra
AU - Catalan, Jose M.
AU - Badesa, Francisco J.
AU - Crea, Simona
AU - Bressi, Federica
AU - Garcia-Aracil, Nicolas
AU - Vitiello, Nicola
AU - Zollo, Loredana
AU - Soekadar, Surjo R.
N1 - Funding Information:
EuropeanCommissionundertheProjectAIDEunderGrant645322,inpartby28,2020;acceptedAugust30,2020.Thisworkwassupportedinpartbythe S TROKE is one of the leading causes for long-term dis- the European Research Council under the Project NGBMI under Grant 759370, ability in the adulthood worldwide [1]. Besides cognitive inpartbytheBaden-WürttembergStiftungunderGrantNEU007/1andthe and sensory impairments, particularly loss of hand and arm withtheRehabRobo@WorkunderGrantCUP:C82F17000040001.TheworkofEinsteinStiftungBerlin,andinpartbytheItalianInstituteforLabourAccidents function impedes the ability of stroke survivors to engage in Surjo R. Soekadar was supported by Brain and Behavior Research Foundation as various activities of daily living (ADLs) such as preparing a 2017NARSADYoungInvestigatorGrantrecipientandP&SFundInvestigator. meal or eating and drinking independently. As a consequence, contributedequallytothiswork.)(Correspondingauthor:SurjoR.Soekadar.)(MariusNann,FrancescaCordella,LoredanaZollo,andSurjoR.Soekadar stroke survivors frequently reported reduced quality of life and Marius Nann and Surjo R. Soekadar are with the Charité – Univer-limited autonomy [2]. Therefore, effective restoration of hand sitätsmedizin,10117Berlin,Germany,andalsowiththeUniversityHospitalof and arm motor function after stroke is of great importance. surjo.soekadar@charite.de).Tübingen,72076Tübingen,Germany(e-mail:marius.nann@uni-tuebingen.de; However, there is no accepted gold standard in the treatment Francesca Cordella, Clemente Lauretti, Marco Bravi, Sandra Miccinilli, of stroke survivors with little or no capacity to move the arm or Federica Bressi, and Loredana Zollo are with the Università Campus Bio- fingers [3], [4]. Most established rehabilitation methods such as c.lauretti@unicampus.it;m.bravi@unicampus.it;s.miccinilli@unicampus.it;Medico di Roma, 00128Rome,Italy (e-mail:f.cordella@unicampus.it; constraint-induced movement therapy [5] require some remain- f.bressi@unicampus.it; l.zollo@unicampus.it). ing grasp function and are therefore not applicable for stroke EmilioTrigiliiswiththeBioRoboticsInstitute,ScuolaSuperioreSant’Anna, survivors with complete hand and finger paralysis. Moreover, JoseM.CatalanandNicolasGarcia-AracilarewithBioengineeringInstitute56025Pontedera,Italy(e-mail:emilio.trigili@santannapisa.it). many stroke survivors also suffer from limited or nonexistent at Miguel Hernandez University of Elche, 03202 Alicante, Spain, and also with arm and shoulder function. theNewTechnologiesforNeurorehabilitationLaboratory,28054Madrid,Spain Recently, it was shown that brain/neural hand exoskeletons FranciscoJ.BadesaiswiththeMiguelHernan´dezUniversityofElche,03202(e-mail:jcatalan@umh.es;nicolas.garcia@umh.es). (B/NHEs) are capable of fully restoring hand and finger function Alicante, Spain, with the New Technologies for Neurorehabilitation Laboratory, despite complete paralysis, e.g., due to cervical spinal cord Madrid,Spain,andalsowiththeUniversidaddeCad´iz,11003Cádiz,Spain injury [6]. Such devices translate modulations of electric, mag-SimonaCreaandNicolaVitielloarewiththeBioRoboticsInstitute,Scuola(e-mail:javier.badesa@uca.es). netic, or metabolic brain activity, e.g., related to imagined or Superiore Sant’Anna, 56025 Pontedera, Italy, with the Department of Excellence attempted movements of the paralyzed fingers, into actual finger inRobotics&AI, ScuolaSuperioreSant’Anna, 56127Pisa, Italy,andalso movements driven by electromechanical actuators [7]–[10]. The simona.crea@santannapisa.it;nicola.vitiello@santannapisa.it).withtheIRCCSFondazioneDonCarloGnocchi,50143Florence,Italy(e-mail: best established approach for such application uses modulations Digital Object Identifier 10.1109/JSYST.2020.3021485 of sensorimotor rhythms (SMR, 8–12 Hz) recorded by EEG 1937-9234 © 2020 IEEE. Personal use is permitted, but republication/redistribution requires IEEE permission. See https://www.ieee.org/publications/rights/index.html for more information.
Publisher Copyright:
© 2020 IEEE. Personal use is permitted, but republication/redistribution requires IEEE permission.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/9
Y1 - 2020/9
N2 - Stroke survivors with chronic paralysis often have difficulties to perform various activities of daily living (ADLs), such as preparing a meal or eating and drinking independently. Recently, it was shown that a brain/neural hand exoskeleton can restore hand and finger function, but many stroke survivors suffer from motor deficits affecting their whole upper limb. Therefore, novel hybrid electroencephalography/electrooculography (EEG/EOG)based brain/neural control paradigms were developed for guiding a whole-arm exoskeleton. It was unclear, however, whether hemiplegic stroke survivors are able to reliably use such brain/neural-controlled device. Here, we tested feasibility, safety, and user-friendliness of EEG/EOG-based brain/neural robotic control across five hemiplegic stroke survivors engaging in a drinking task that consisted of several subtasks (e.g., reaching, grasping, manipulating, and drinking). Reliability was assumed when at least 75% of subtasks were initialized within 3 s. Fluent control was assumed if average “time to initialize” each subtask ranged below 3 s. System's safety and user-friendliness were rated using Likert-scales. All chronic stroke patients were able to operate the system reliably and fluently. No undesired side effects were reported. Four participants rated the system as very user-friendly. These results show that chronic stroke survivors are capable of using an EEG/EOG-controlled semiautonomous whole-arm exoskeleton restoring ADLs.
AB - Stroke survivors with chronic paralysis often have difficulties to perform various activities of daily living (ADLs), such as preparing a meal or eating and drinking independently. Recently, it was shown that a brain/neural hand exoskeleton can restore hand and finger function, but many stroke survivors suffer from motor deficits affecting their whole upper limb. Therefore, novel hybrid electroencephalography/electrooculography (EEG/EOG)based brain/neural control paradigms were developed for guiding a whole-arm exoskeleton. It was unclear, however, whether hemiplegic stroke survivors are able to reliably use such brain/neural-controlled device. Here, we tested feasibility, safety, and user-friendliness of EEG/EOG-based brain/neural robotic control across five hemiplegic stroke survivors engaging in a drinking task that consisted of several subtasks (e.g., reaching, grasping, manipulating, and drinking). Reliability was assumed when at least 75% of subtasks were initialized within 3 s. Fluent control was assumed if average “time to initialize” each subtask ranged below 3 s. System's safety and user-friendliness were rated using Likert-scales. All chronic stroke patients were able to operate the system reliably and fluently. No undesired side effects were reported. Four participants rated the system as very user-friendly. These results show that chronic stroke survivors are capable of using an EEG/EOG-controlled semiautonomous whole-arm exoskeleton restoring ADLs.
KW - Activities of daily living (ADL)
KW - Brain-computer interface (BCI)
KW - Brain-machine interface (BMI)
KW - Chronic stroke
KW - Electroencephalography (EEG)
KW - Electrooculography (EOG)
KW - Exoskeletons
KW - Hemiparesis
KW - Rehabilitation robotics
KW - Sensorimotor rhythms
KW - Shared control
UR - http://www.scopus.com/inward/record.url?scp=85095953676&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85095953676&partnerID=8YFLogxK
U2 - 10.1109/JSYST.2020.3021485
DO - 10.1109/JSYST.2020.3021485
M3 - Article
AN - SCOPUS:85095953676
JO - IEEE Systems Journal
JF - IEEE Systems Journal
SN - 1932-8184
M1 - 9199380
ER -