Effects of Action Observational Training Plus Brain–Computer Interface‐Based Functional Electrical Stimulation on Paretic Arm Motor Recovery in Patient with Stroke: A Randomized Controlled Trial

Abstract The purpose of this study was to investigate whether action observational training (AOT) plus brain–computer interface‐based functional electrical stimulation (BCI‐FES) has a positive influence on motor recovery of paretic upper extremity in patients with stroke. This was a hospital‐based, randomized controlled trial with a blinded assessor. Thirty patients with a first‐time stroke were randomly allocated to one of two groups: the BCI‐FES group ( n = 15) and the control group ( n = 15). The BCI‐FES group administered to AOT plus BCI‐FES on the paretic upper extremity five times per week during 4 weeks while both groups received conventional therapy. The primary outcomes were the Fugl‐Meyer Assessment of the Upper Extremity, Motor Activity Log (MAL), Modified Barthel Index and range of motion of paretic arm. A blinded assessor evaluated the outcomes at baseline and 4 weeks. All baseline outcomes did not differ significantly between the two groups. After 4 weeks, the Fugl‐Meyer Assessment of the Upper Extremity sub‐items (total, shoulder and wrist), MAL (MAL‐Activity of Use and Quality of Movement), Modified Barthel Index and wrist flexion range of motion were significantly higher in the BCI‐FES group ( p < 0.05). AOT plus BCI‐based FES is effective in paretic arm rehabilitation by improving the upper extremity performance. The motor improvements suggest that AOT plus BCI‐based FES can be used as a therapeutic tool for stroke rehabilitation. The limitations of the study are that subjects had a certain limited level of upper arm function, and the sample size was comparatively small; hence, it is recommended that future large‐scale trials should consider stratified and lager populations according to upper arm function. Copyright © 2015 John Wiley & Sons, Ltd.