EEG and Motor Effects of Multimodal Feedback to Train Functional Grasp after Traumatic Brain Injury

Physical therapy is crucial to rehabilitating hand function needed for activities of daily living after neurological traumas such as traumatic brain injury (TBI). Virtual reality (VR) can motivate participation in motor rehabilitation therapies. Computerized interfaces like VR could be further leveraged to provide augmented feedback during training that accelerates motor learning. In prior work, our lab demonstrated improved performance of a functional grasp task after training with augmented feedback from a glove. The glove has modules and computational intelligence to detect and cue users about secure grasp. In this study, we incorporated VR with the glove to enhance the augmented feedback. We then examined how multimodal (audio and visual cues) feedback impacted performance and neurological responses compared to unimodal feedback (audio cues only) after TBI (n=5) versus neurotypicals (n=10). After training with multimodal feedback for a grasp-andplace task, electroencephalography (EEG) alpha power significantly increased for TBI and neurotypical groups. However, only the TBI group significantly improved performance (i.e., reduced motion pathlength). These results suggest a neurological basis for the benefits of training with multimodal feedback. Adding sensory cues may better consolidate early motor learning in the presence of neurological dysfunction, as indicated by higher alpha activity with improved performance. Computerized interfaces such as virtual reality offer a powerful platform to customize rehabilitative training and improve functional outcomes according to specific neurological states.