PTOTSystematic ReviewJournal of neuroengineering and rehabilitation2022

Determining optimal mobile neurofeedback methods for motor neurorehabilitation in children and adults with non-progressive neurological disorders: a scoping review.

Ahad Behboodi, Walker A Lee, Victoria S Hinchberger and 1 others

PMID 36171602

WHAT IT FOUND

Across 30 studies in 223 adults, brain-computer interface training improved motor scores, but gains were inconsistent and often not clinically significant.

More sessions correlated with better outcomes, but no single feedback method proved superior.

Key findings

01Mean Fugl-Meyer Assessment scores improved by 6.53 points, but when compared against control groups, the mean difference was only 4.06 points, which did not reach the threshold for clinical significance.

02There was a moderate positive relationship between the number of training sessions and motor improvement, with more sessions associated with better outcomes.

03Functional electrical stimulation and robotic feedback produced similar motor outcomes, with no statistically significant difference in effectiveness between the two methods.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

The review included only 30 studies with 223 participants, resulting in low statistical power for subgroup analyses. Study designs varied widely, with many being small randomized controlled trials or case series, limiting the certainty of the evidence. Outcome measures were not consistent across all studies, making it difficult to pool data for a robust meta-analysis. The review excluded studies using motor imagery, so findings apply only to motor attempt paradigms.

Declared interests

The study was funded by the National Institutes of Health.

The easy way to misread this

Do not assume that statistically significant improvements in motor scores equate to clinically meaningful recovery. The mean difference between neurofeedback and control groups did not reach the minimal clinically important difference threshold, suggesting the real-world benefit may be smaller than the raw scores imply.

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