Brain-Neural Computer Interaction for  Evaluation and Testing of Physical Therapies in Stroke Rehabilitation of Gait Disorders

The principal goal of BETTER - a STREP Project in the ICT area under the European Community's 7th Framework Programme (FP7) - is to improve physical rehabilitation therapies of gait disorders in stroke patients based on BNCI assistive technologies, producing improved systems, providing guidelines for improving future systems, and developing benchmarking and evaluation tools. The project will validate, technically, functionally and clinically, the concept of improving stroke rehabilitation with wearable exoskeletons and robotic gait trainers based on a TOP DOWN approach: The robot exerts physical stimulation - at the periphery - as a function of targeted neural activation patterns (related to user involvement).

Different active areas in the brain.

BETTER adopts the TOP DOWN approach for gait training in which such assistive technologies (ATs) can be improved if combined with non-invasive BNCI in order to increase the effectiveness in recovering function. The level of assistance is applied as needed by the patient, according to novel metrics that inform about the patient adherence in combination with the functional outcome; this assistance is intended to provide the different afferent cues regarded as critical to retraining locomotion. The new interventions are expected to result in reorganizations in the cortex. Such TOP-DOWN therapeutic treatment would aim to encourage plasticity of the affected brain structures to improve motor function.

In order to achieve its goals, the project builds on consortium partners' experience in the multiple areas (including robotics - prosthetics/orthotics, BCIs, neurorehabilitation, motion analysis and neurophysiology). The consortium consists of three groups: a robotic group - Consejo Superior de Investigaciones Científicas ( Madrid, ES), Instituto de Biomecánica de Valencia (Valencia, ES), Ossur hf (Reykjiavik, IC) and Technaid SL (Madrid, ES); BNCI group - Guger Technologies OG (Graz, AU), Technische Uni Graz (Graz, AU), Aalborg University (Aalborg, DE) and University of Tübingen (Tübingen, GE); and a medical partner represented by Fondazione Santa Lucia (Roma, IT).

The main role of g.tec concerns the integration and optimization of all system's components into the therapy robot and the ambulatory exoskeleton. Additionally, g.tec is involved in further investigation of BNCI strategies for stroke rehabilitation. Therefore, physiological signals such as EMG signals, acceleration signals for gait pattern analysis and activity index evaluation, as well as EEG signals to explore the representations in the cortex and characterize the user involvement, will be exploited to modify the intervention at the periphery with ambulatory and non-ambulatory robotic gait trainers.

The approach adopted in BETTER is expected to contribute to the practical spread of BNCI-based technologies, directly in stroke rehabilitation, and indirectly by showing the way to a non-invasive, cosmetic, robust and cost affordable management of other disabilities through BNCI systems. The open source approach adopted by BETTER as to BNCI technologies will support wide adoption of these technologies and will contribute to the European excellence in this field.