EEG-Controlled Functional Electrical Stimulation Therapy With Automated Grasp Selection: A Proof -of-Concept Study

Background: Functional electrical stimulation therapy (FEST) is a promising intervention for the restoration of upper extremity function after cervical spinal cord injury (SCI). Objectives: This study describes and evaluates a novel FEST system designed to incorporate voluntary movement attempts and massed practice of functional grasp through the use of brain-computer interface (BCI) and computer vision (CV) modules. Methods: An EEG-based BCI relying on a single electrode was used to detect movement initiation attempts. A CV system identified the target object and selected the appropriate grasp type. The required grasp type and trigger command were sent to an FES stimulator, which produced one of four multichannel muscle stimulation patterns (precision, lateral, palmar, or lumbrical grasp). The system was evaluated with five neurologically intact participants and one participant with complete cervical SCI. Results: An integrated BCI-CV-FES system was demonstrated. The overall classification accuracy of the CV module was 90.8%, when selecting out of a set of eight objects. The average latency for the BCI module to trigger the movement across all participants was 5.9 +/- 1.5 seconds. For the participant with SCI alone, the CV accuracy was 87.5% and the BCI latency was 5.3 +/- 9.4 seconds. Conclusion: BCI and CV methods can be integrated into an FEST system without the need for costly resources or lengthy setup times. The result is a clinically relevant system designed to promote voluntary movement attempts and more repetitions of varied functional grasps during FEST.