Case Report of Functional Electrical Stimulation Application Combined With Visually Assisted Brain Computer Interface in Stroke Patients

Abstract

Stroke is one of the leading causes of death and disability worldwide. Upper extremity motor deficits frequently persist after stroke, leading to significant functional limitations and dependence in daily activities. In recent years, brain–computer interface (BCI) technologies combined with functional electrical stimulation (FES) have been explored as innovative rehabilitation tools for enhancing motor recovery. We report three hemiplegic patients who underwent a visual-guided BCI combined with FES program, in addition to conventional rehabilitation. Each session consisted of a 30-min preparation and a 30-min treatment phase, five times a week for a total of 24 sessions. During the treatment phase, FES was triggered only when motor imagery-related EEG patterns were detected, enabling real-time patient engagement. Clinical outcomes, including Brunnstrom stages, Fugl-Meyer Assessment (FMA), and Barthel Index scores, were evaluated before and after the intervention. Improvements in upper extremity motor function and daily living activities were observed in all three cases, particularly in wrist and hand motor control. The combination of visual-guided BCI and FES may represent a promising adjunctive rehabilitation approach for stroke patients with severe motor impairment, particularly for those who are unable to actively participate in conventional rehabilitation. However, these preliminary findings should be interpreted cautiously, and further randomized controlled trials with larger sample sizes are required to validate their clinical efficacy.