Novel Upper-Limb Rehabilitation System Based on Attention Technology for Post-Stroke Patients: A Preliminary Study

In this paper, we proposed an upper-limb post-stroke rehabilitation system integrating a motion tracking device (MTD), a portable electroencephalogram (EEG) device for an attentional feedback, and interactive virtual reality (VR) game with the goal to assist patients in upper-limb rehabilitation. Fifteen post-stroke patients were recruited and randomly assigned to a control group (A) or one of two experimental groups (B and C). Group B played the game using a MTD and group C played it using a MTD and brain-computer-interface-based attention-monitoring EEG device. In group C, patients' attention was measured in real time using the EEG while the patients performed tasks; visual and auditory stimuli were emitted when their attention lowered. The primary outcome was a change in score on the upper extremity section of the Fugl-Meyer assessment, which was used to evaluate the severity of motor impairment and indicate any improvement of motor function. Improvement in motor function, associated with game performance, was found in group C. Based on their performance quality during 12 training sessions, the higher performance of group C patients in the VR game was significantly correlated with attention level and motor performance. Higher attention level is associated with higher game performance after 12 training sessions, and our MTD-EEG-VR training system may facilitate the improvement of motor function and assist patients in upper-limb rehabilitation. Our MTD-EEG-VR game with the attentional EEG-feedback device is a potential intervention for improving motor function in patients with stroke.