Publicação
Recommendations for combining brain-computer interface, motor imagery and virtual reality in upper limb stroke rehabilitation: a qualitative person-centered study
| Resumo: | Background: The high incidence and prevalence of upper limb impairment poststroke highlights the need for the development of rehabilitation in this field. BrainComputer Interfaces (BCIs) can directly train the central nervous system providing promising technology in this area and the use of associated motor imagery (MI) and virtual reality (VR) can provide valuable rehabilitative opportunities. However, the diversity in interventions designs demonstrates the lack of guiding recommendations integrating neurorehabilitation principles for BCI. Objective: This study aims to develop recommendations for BCI interventions using task specificity and ecological validity through simulated VR tasks for upper limb stroke survivors, by gathering tacit knowledge from neurorehabilitation experts, patients’ experiences, and engineers’ expertise to ensure a comprehensive approach. Methods: a multi-perspective qualitative study was conducted through collaborative design workshops involving stroke survivors (N=17), rehabilitation experts (N=13) and biomedical engineers (N=3), totaling 33 participants. This innovative approach aimed to actively engage stakeholders in developing multifaceted solutions for complex health interventions. Results: Six themes emerged from the thematic analysis: i) Importance of patient centred approach; ii) Clinical evaluation and patient selection; iii) Recommendations for task design; iv) Guidelines for structuring BCI intervention; v) Key factors influencing motivation; and vi) Technology features. From these themes, the following recommendations (R) are established: R1 - BCI-MI-VR interventions must be conducted through a Patient Centered Approach, based on individualized preferences, needs and goals of the user, by an interdisciplinary team; R2 - Selection criteria must include upper limb impairment, cognitive and communication assessment and clinical traits like motor imagery capacity, neglect and depression must be assessed once it might influence intervention outcomes; R3 - Tasks to perform should preferably be based on daily living activities including unilateral and bilateral tasks and a variety of tasks must be available for selection to ensure significance for the user and adequation to clinical traits; R4 - Intervention must be structured by different progressing levels starting with simple, gross movements and adding complexity through movement features, cognitive demand and motor imagery difficulty; R5 - Optimal levels of motivation must be sustained through task variability, gamification elements and task demand adequacy; R6 - Multisensorial potential of BCI-MI-VR must be effectively harnessed through the adequate adjustment of visual, haptic and proprioceptive feedback modalities to the patient. Conclusions: These results contribute to establishing clear guidelines on patient selection, task design, intervention structuring, motivation factors and tailoring of sensory feedback. This framework presents a foundation for optimal implementation of BCI-MI-VR based interventions, optimizing cortical activity during the intervention, patients’ engagement and clinical outcomes. Future research should explore the application of these guidelines for validation and investigate BCI’s efficacy according to different combinations of patients’ profiles, task characteristics and technology features. |
|---|---|
| Autores principais: | Oliveira, Inês Catarina Rodrigues |
| Assunto: | Neurological Rehabilitation Cerebrovascular Disorders Upper Extremity Brain-computer interfaces Health Planning Guidelines Qualitative Research User-Centered Design |
| Ano: | 2024 |
| País: | Portugal |
| Tipo de documento: | dissertação de mestrado |
| Tipo de acesso: | acesso embargado |
| Instituição associada: | Instituto Politécnico de Setúbal |
| Idioma: | inglês |
| Origem: | Instituto Politécnico de Setúbal |
| _version_ | 1865920209134551041 |
|---|---|
| author | Oliveira, Inês Catarina Rodrigues |
| author_facet | Oliveira, Inês Catarina Rodrigues Oliveira, Inês Catarina Rodrigues |
| author_role | author |
| contributor_name_str_mv | Pereira, Carla Mendes Almeida, Ana Isabel Vourvopoulos, Athanasios Repositório Comum |
| country_str | PT |
| creators_json_str | [{\"Person.name\":\"Oliveira, Inês Catarina Rodrigues\"}] |
| datacite.contributors.contributor.contributorName.fl_str_mv | Pereira, Carla Mendes Almeida, Ana Isabel Vourvopoulos, Athanasios Repositório Comum |
| datacite.creators.creator.creatorName.fl_str_mv | Oliveira, Inês Catarina Rodrigues |
| datacite.date.Accepted.fl_str_mv | 2024-12-01T00:00:00Z |
| datacite.date.available.fl_str_mv | 2026-01-01T00:00:00Z |
| datacite.date.embargoed.fl_str_mv | 2026-01-01T00:00:00Z |
| datacite.rights.fl_str_mv | http://purl.org/coar/access_right/c_f1cf |
| datacite.subjects.subject.fl_str_mv | Neurological Rehabilitation Cerebrovascular Disorders Upper Extremity Brain-computer interfaces Health Planning Guidelines Qualitative Research User-Centered Design |
| datacite.titles.title.fl_str_mv | Recommendations for combining brain-computer interface, motor imagery and virtual reality in upper limb stroke rehabilitation: a qualitative person-centered study |
| dc.contributor.none.fl_str_mv | Pereira, Carla Mendes Almeida, Ana Isabel Vourvopoulos, Athanasios Repositório Comum |
| dc.creator.none.fl_str_mv | Oliveira, Inês Catarina Rodrigues |
| dc.date.Accepted.fl_str_mv | 2024-12-01T00:00:00Z |
| dc.date.available.fl_str_mv | 2026-01-01T00:00:00Z |
| dc.date.embargoed.fl_str_mv | 2026-01-01T00:00:00Z |
| dc.format.none.fl_str_mv | application/pdf |
| dc.identifier.none.fl_str_mv | http://hdl.handle.net/10400.26/54335 |
| dc.language.none.fl_str_mv | eng |
| dc.rights.none.fl_str_mv | http://purl.org/coar/access_right/c_f1cf |
| dc.subject.none.fl_str_mv | Neurological Rehabilitation Cerebrovascular Disorders Upper Extremity Brain-computer interfaces Health Planning Guidelines Qualitative Research User-Centered Design |
| dc.title.fl_str_mv | Recommendations for combining brain-computer interface, motor imagery and virtual reality in upper limb stroke rehabilitation: a qualitative person-centered study |
| dc.type.none.fl_str_mv | http://purl.org/coar/resource_type/c_bdcc |
| description | Background: The high incidence and prevalence of upper limb impairment poststroke highlights the need for the development of rehabilitation in this field. BrainComputer Interfaces (BCIs) can directly train the central nervous system providing promising technology in this area and the use of associated motor imagery (MI) and virtual reality (VR) can provide valuable rehabilitative opportunities. However, the diversity in interventions designs demonstrates the lack of guiding recommendations integrating neurorehabilitation principles for BCI. Objective: This study aims to develop recommendations for BCI interventions using task specificity and ecological validity through simulated VR tasks for upper limb stroke survivors, by gathering tacit knowledge from neurorehabilitation experts, patients’ experiences, and engineers’ expertise to ensure a comprehensive approach. Methods: a multi-perspective qualitative study was conducted through collaborative design workshops involving stroke survivors (N=17), rehabilitation experts (N=13) and biomedical engineers (N=3), totaling 33 participants. This innovative approach aimed to actively engage stakeholders in developing multifaceted solutions for complex health interventions. Results: Six themes emerged from the thematic analysis: i) Importance of patient centred approach; ii) Clinical evaluation and patient selection; iii) Recommendations for task design; iv) Guidelines for structuring BCI intervention; v) Key factors influencing motivation; and vi) Technology features. From these themes, the following recommendations (R) are established: R1 - BCI-MI-VR interventions must be conducted through a Patient Centered Approach, based on individualized preferences, needs and goals of the user, by an interdisciplinary team; R2 - Selection criteria must include upper limb impairment, cognitive and communication assessment and clinical traits like motor imagery capacity, neglect and depression must be assessed once it might influence intervention outcomes; R3 - Tasks to perform should preferably be based on daily living activities including unilateral and bilateral tasks and a variety of tasks must be available for selection to ensure significance for the user and adequation to clinical traits; R4 - Intervention must be structured by different progressing levels starting with simple, gross movements and adding complexity through movement features, cognitive demand and motor imagery difficulty; R5 - Optimal levels of motivation must be sustained through task variability, gamification elements and task demand adequacy; R6 - Multisensorial potential of BCI-MI-VR must be effectively harnessed through the adequate adjustment of visual, haptic and proprioceptive feedback modalities to the patient. Conclusions: These results contribute to establishing clear guidelines on patient selection, task design, intervention structuring, motivation factors and tailoring of sensory feedback. This framework presents a foundation for optimal implementation of BCI-MI-VR based interventions, optimizing cortical activity during the intervention, patients’ engagement and clinical outcomes. Future research should explore the application of these guidelines for validation and investigate BCI’s efficacy according to different combinations of patients’ profiles, task characteristics and technology features. |
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| institution | Instituto Politécnico de Setúbal |
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| organization_str_mv | urn:organizationAcronym:ips |
| person_str_mv | Oliveira, Inês Catarina Rodrigues |
| publishDate | 2024 |
| reponame_str | Instituto Politécnico de Setúbal |
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| spelling | engpt_PTBackground: The high incidence and prevalence of upper limb impairment poststroke highlights the need for the development of rehabilitation in this field. BrainComputer Interfaces (BCIs) can directly train the central nervous system providing promising technology in this area and the use of associated motor imagery (MI) and virtual reality (VR) can provide valuable rehabilitative opportunities. However, the diversity in interventions designs demonstrates the lack of guiding recommendations integrating neurorehabilitation principles for BCI. Objective: This study aims to develop recommendations for BCI interventions using task specificity and ecological validity through simulated VR tasks for upper limb stroke survivors, by gathering tacit knowledge from neurorehabilitation experts, patients’ experiences, and engineers’ expertise to ensure a comprehensive approach. Methods: a multi-perspective qualitative study was conducted through collaborative design workshops involving stroke survivors (N=17), rehabilitation experts (N=13) and biomedical engineers (N=3), totaling 33 participants. This innovative approach aimed to actively engage stakeholders in developing multifaceted solutions for complex health interventions. Results: Six themes emerged from the thematic analysis: i) Importance of patient centred approach; ii) Clinical evaluation and patient selection; iii) Recommendations for task design; iv) Guidelines for structuring BCI intervention; v) Key factors influencing motivation; and vi) Technology features. From these themes, the following recommendations (R) are established: R1 - BCI-MI-VR interventions must be conducted through a Patient Centered Approach, based on individualized preferences, needs and goals of the user, by an interdisciplinary team; R2 - Selection criteria must include upper limb impairment, cognitive and communication assessment and clinical traits like motor imagery capacity, neglect and depression must be assessed once it might influence intervention outcomes; R3 - Tasks to perform should preferably be based on daily living activities including unilateral and bilateral tasks and a variety of tasks must be available for selection to ensure significance for the user and adequation to clinical traits; R4 - Intervention must be structured by different progressing levels starting with simple, gross movements and adding complexity through movement features, cognitive demand and motor imagery difficulty; R5 - Optimal levels of motivation must be sustained through task variability, gamification elements and task demand adequacy; R6 - Multisensorial potential of BCI-MI-VR must be effectively harnessed through the adequate adjustment of visual, haptic and proprioceptive feedback modalities to the patient. Conclusions: These results contribute to establishing clear guidelines on patient selection, task design, intervention structuring, motivation factors and tailoring of sensory feedback. This framework presents a foundation for optimal implementation of BCI-MI-VR based interventions, optimizing cortical activity during the intervention, patients’ engagement and clinical outcomes. Future research should explore the application of these guidelines for validation and investigate BCI’s efficacy according to different combinations of patients’ profiles, task characteristics and technology features.application/pdfpt_PTRecommendations for combining brain-computer interface, motor imagery and virtual reality in upper limb stroke rehabilitation: a qualitative person-centered studyOliveira, Inês Catarina RodriguesPereira, Carla MendesAlmeida, Ana IsabelVourvopoulos, AthanasiosHostingInstitutionOrganizationalRepositório Comume-mailmailto:comum@rcaap.ptcomum@rcaap.ptURNurn:tid:2037999922024-122024-12-01T00:00:00Z2026-01-01T00:00:00ZHandlehttp://hdl.handle.net/10400.26/54335http://purl.org/coar/access_right/c_f1cfembargoed accessNeurological RehabilitationCerebrovascular DisordersUpper ExtremityBrain-computer interfacesHealth Planning GuidelinesQualitative ResearchUser-Centered Design1615147 bytesliteraturehttp://purl.org/coar/resource_type/c_bdccmaster thesishttp://purl.org/coar/access_right/c_f1cfapplication/pdffulltexthttps://comum.rcaap.pt/bitstreams/ce1217a0-b7b1-466a-bb3c-288c6f6aa985/download |
| spellingShingle | Recommendations for combining brain-computer interface, motor imagery and virtual reality in upper limb stroke rehabilitation: a qualitative person-centered study Recommendations for combining brain-computer interface, motor imagery and virtual reality in upper limb stroke rehabilitation: a qualitative person-centered study Oliveira, Inês Catarina Rodrigues Neurological Rehabilitation Cerebrovascular Disorders Upper Extremity Brain-computer interfaces Health Planning Guidelines Qualitative Research User-Centered Design Oliveira, Inês Catarina Rodrigues Neurological Rehabilitation Cerebrovascular Disorders Upper Extremity Brain-computer interfaces Health Planning Guidelines Qualitative Research User-Centered Design |
| status | NEW |
| subject.fl_str_mv | Neurological Rehabilitation Cerebrovascular Disorders Upper Extremity Brain-computer interfaces Health Planning Guidelines Qualitative Research User-Centered Design |
| title | Recommendations for combining brain-computer interface, motor imagery and virtual reality in upper limb stroke rehabilitation: a qualitative person-centered study |
| title_full | Recommendations for combining brain-computer interface, motor imagery and virtual reality in upper limb stroke rehabilitation: a qualitative person-centered study |
| title_fullStr | Recommendations for combining brain-computer interface, motor imagery and virtual reality in upper limb stroke rehabilitation: a qualitative person-centered study Recommendations for combining brain-computer interface, motor imagery and virtual reality in upper limb stroke rehabilitation: a qualitative person-centered study |
| title_full_unstemmed | Recommendations for combining brain-computer interface, motor imagery and virtual reality in upper limb stroke rehabilitation: a qualitative person-centered study Recommendations for combining brain-computer interface, motor imagery and virtual reality in upper limb stroke rehabilitation: a qualitative person-centered study |
| title_short | Recommendations for combining brain-computer interface, motor imagery and virtual reality in upper limb stroke rehabilitation: a qualitative person-centered study |
| title_sort | Recommendations for combining brain-computer interface, motor imagery and virtual reality in upper limb stroke rehabilitation: a qualitative person-centered study |
| topic | Neurological Rehabilitation Cerebrovascular Disorders Upper Extremity Brain-computer interfaces Health Planning Guidelines Qualitative Research User-Centered Design |
| topic_facet | Neurological Rehabilitation Cerebrovascular Disorders Upper Extremity Brain-computer interfaces Health Planning Guidelines Qualitative Research User-Centered Design |
| url | http://hdl.handle.net/10400.26/54335 |
| visible | 1 |