Brain-computer interfaces and electromyostimulation in the rehabilitation of stroke patients: impact on emotional state, daily functioning and quality of life

SUMMARY
Relevance. The effectiveness of medical rehabilitation (MR) of stroke patients depends on their emotional status. The prevalence of depression varies from 35% in the acute period to 44.7% in the early recovery period.
Aim. To study the effect of robotic brain-computer interfaces (BCI) and electromyostimulation (EMS) on the emotional state, daily functioning, and quality of life of patients with ischemic stroke (IS).
Matherials and methods. The study included 120 patients with IS. The patients were randomized into one of 4 groups, 30 people each: the main group, MG (basic complex MR, robotic BCI and EMS); comparison group 1 (basic complex and robotic BCI); comparison group 2 (basic complex and EMS); control group (basic complex MR). Over time (1 week, 2 weeks, 3 months), functional independence (Barthel index, BI), quality of life of patients (EQ‑5D questionnaire), and emotional state were assessed on the HADS.
Results. The average age of patients was 56.54±2.53 years, and the duration of IS was 48.7 ± 3.5 days. The average values on the HADS corresponded to subclinically expressed anxiety (9.46±0.50 points) and subclinically expressed depression (8.85±0.58 points), BI to moderate restrictions on daily activity (63.92 ± 0.23 points), the EQ‑5D questionnaire data to the presence of health-related difficulties (43.99±5.45 points). After the MR, significant positive changes were noted in the MG: the total score on the «Anxiety» subscale decreased by 53.9% after 2 weeks, by 55.6% after 3 months, and on the «Depression» subscale by 50.1% and 62.3%, respectively. An increase in the average score of the BI had a significantly greater increase in MG. There was an increase in the quality of life according to EQ‑5D in all groups with significantly better values in the MH (2 weeks – 71.55±5.45 points, 3 months – 84.65±6.10 points).
Conclusions. Against the background of the use of comprehensive rehabilitation programs with the inclusion of robotic BCI and EMS, a regression of emotional disorders, an increase in functional independence and quality of life of patients with IS.

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