Advancing Brain–Computer Interface Systems for Stroke Motor Recovery: An Umbrella Review of Meta-Analyses

Abstract

This review examined cumulative findings from recent meta-analyses to identify current challenges and possible suggestions for improving the effects of BCI systems on stroke motor recovery. Consistent with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic literature search was conducted using PubMed, Web of Science, and the Cochrane Library on 30 June 2026. A total of 17 systematic reviews and meta-analyses were included. Among three motor intent-induced (i.e., motor attempt, motor observation, and motor imagery) modalities, motor attempt was the modality most consistently associated with significant therapeutic effects across meta-analyses. Electrical stimulation was a consistently effective feedback modality, whereas robot-assisted and visual feedback showed heterogeneous effects. Higher weekly session frequencies and moderate session durations (approximately 20–60 min) showed consistent motor recovery. Stroke type, age, intervention period, total sessions, total training time, and long-term effect durability were inconsistent across the included evidence. These findings suggest that applying BCI-based training is an effective rehabilitation program for the functional recovery of upper extremities in patients with stroke who have moderate to severe motor impairments, potentially achieving greater therapeutic efficacy when combining motor attempts with electrical stimulation.