Brain-computer interface for upper limb functional recovery post-stroke: a meta-analysis of improvement in upper limb motor function and changes in neurophysiological markers.

Journal of neuroengineering and rehabilitation · 2026 · Meta-Analysis · PT · OT
Huanhuan Zhang, Runzhi Xian, Yuchi Zhang, Xiaoyu Liu, Guoqiang Yang, Guiquan Chen

BCI training added to standard stroke rehab improved upper limb movement scores across 16 trials. The benefit was clearest in the subacute phase; in chronic stroke it did not reach significance. Consider BCI as an adjunct for subacute upper limb rehab, not a replacement.

Key findings

1

Compared with conventional rehabilitation, BCI-based training produced a statistically significant improvement in upper limb motor function (Fugl-Meyer Assessment for Upper Extremity), with a moderate pooled effect (SMD = 0.49, 95% CI 0.26 to 0.73, p = 0.037).

2

The benefit was phase-dependent: subacute stroke patients showed the largest improvement (SMD = 0.62, p = 0.031), while chronic stroke patients showed a non-significant effect (SMD = 0.40, p = 0.152).

3

14 of the 16 included trials (87.5%) were rated high risk of bias for participant and personnel blinding, because the BCI equipment and active training made it impossible to disguise the intervention from patients or therapists.

MethodologyResultsClinical Relevance

Single-blind randomized controlled trial. Sixty-four participants were randomized across two intervention arms and assessed at twelve weeks for the primary outcome…

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