Motor priming to enhance the effect of physical therapy in people with spinal cord injury

The Journal of Spinal Cord Medicine, 2025 · DOI: 10.1080/10790268.2024.2317011 · Published: February 16, 2024

Spinal Cord Injury Neurology Neurorehabilitation

Simple Explanation

This study explores whether priming the brain with BCI-FES before physical therapy can improve outcomes for individuals with spinal cord injury compared to physical therapy alone. BCI-FES involves using a brain-computer interface to control functional electrical stimulation. Ten participants with subacute SCI were divided into two groups: one receiving BCI-FES priming before physical practice and the other receiving physical practice alone. The study measured BCI accuracy, adherence, workload, muscle strength, grip strength, range of motion, and brain activity. The results showed that while BCI-FES priming is feasible, it may require longer than 15 minutes to be effective. Although there were no significant differences in physical outcomes, neurological assessments indicated potential benefits in brain activity for the group receiving BCI-FES priming.

Study Duration

Not specified

Participants

10 people with subacute SCI

Evidence Level

Randomized controlled feasibility trial

Key Findings

1
The average BCI accuracy was 85%, indicating the feasibility of using BCI-FES in this population.
2
There were no significant differences in physical outcomes (muscle strength, grip strength, range of motion) between the BCI-FES priming group and the physical practice alone group.
3
The experimental group showed increased EC/EO reactivity, suggesting potential positive effects on brain thalamocortical function compared to the control group, where reactivity decreased.

Research Summary

This study investigated the feasibility and potential benefits of using BCI-FES priming before physical therapy in individuals with subacute SCI. The results indicate that BCI-FES priming is feasible and may lead to positive changes in EEG-based neurological outcomes, but it did not demonstrate significant improvements in physical outcomes compared to physical practice alone. The study suggests that future research should explore longer priming times and larger sample sizes to further investigate the potential benefits of BCI-FES priming in SCI rehabilitation.

Practical Implications

Clinical Practice

BCI-FES priming can be integrated into neurorehabilitation programs for SCI patients, but the duration of priming may need to be optimized.

Research

Further studies are warranted to explore the effects of longer BCI-FES priming sessions and to identify specific patient subgroups that may benefit most from this intervention.

Technology Development

The findings support the continued development and refinement of BCI-FES systems for neurorehabilitation, with a focus on optimizing priming protocols and tailoring interventions to individual patient needs.

Study Limitations

1
The sample size of 10 participants was small, which may have limited the statistical power to detect significant differences in physical outcomes.
2
The duration of BCI-FES priming (15 min) may have been insufficient to induce significant functional changes.
3
The physical therapy exercises were not standardized across participants, which may have introduced variability in the intervention.

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