EU - Better - BNCI-driven Robotic Physical Therapies in Stroke Rehabilitation of Gait Disorders

Cerebral vascular accident (CVA, Stroke) is the most prevalent neurological condition leading to physical impairment in Western society. About 4.7 million stroke survivors are alive today. Impaired walking ability contributes to post-stroke walking disability. Walking incorrectly creates a stigma and makes patients more susceptible to injury, affecting quality of life. Most promising interventions to restore walking function are based on robotic systems that intend to restore function by focusing on actions at periphery of the body (a BOTTOM-UP approach). It is not clear how effective these treatments are and a major problem is non-compliance or non-adherence to the therapy. The main objective of the project is to improve physical rehabilitation therapies of gait disorders in stroke patients based on Brain-Neural Computer Interaction (BNCI) assistive technologies, improving systems, providing guidelines for further improvements, and developing benchmarking tools. The project will validate, technically, functionally and clinically, the concept of improving stroke rehabilitation with robotic exoskeletons based on a TOP-DOWN approach: motor patterns of the limbs are represented in the cortex, transmitted to the limbs and fed back to the cortex: -The system will provide means to assess patient adherence to therapy through a multimodal BNCI. -The proposed BNCI will combine multiple levels of neural information with the resulting motion (biomechanical) data. -It will determine if training the activation of signals that control lower limb tasks in combination with robotics devices is beneficial for restoring lower limb function. -BETTER will provide means for objective evaluation of the BNCI-based physical rehabilitation therapy and its usability and acceptability. BETTER proposes a multimodal BNCI which main goal is to explore the representations in the cortex, characterize the user involvement and modify the intervention at the periphery with ambulatory and non-ambulatory robotic gait trainers.