RESUMEN
Abstract Brain-Computer Interfaces (BCI) decode users' intentions from the central nervous system and could be applied for upper limb motor rehabilitation of patients that have suffered stroke, one of the main causes of disability worldwide. Despite that research groups have reported the efficacy of these systems, a consensus has not yet been reached regarding their true potential. For this reason, a review of up-to-date assessments of BCI for upper limb stroke rehabilitation is presented from the perspective of analyzing common and different design variables presented across studies. Clinical and pilot studies with a control group were included in the review. Most BCI interventions assessments were performed with robotic assistive devices as feedback, followed by neuromuscular electrical stimulation (NMES) and visual feedbacks. Compared to other experimental interventions, the effects of a BCI intervention have been reported in a low number of patients. In addition, high variability between studies' designs such as stroke etiology and interventions' duration, do not allow to assess the potential of BCI for stroke rehabilitation. However, a trend towards significant rehabilitation outcomes with BCI systems can be highlighted, encouraging research groups to better coordinate in order to make valuable contributions to the field.
Resumen Las interfaces cerebro-computadora (BCI) decodifican del sistema nervioso central las intenciones de los usuarios, y pueden ser aplicadas para la rehabilitación motora del miembro superior de pacientes con enfermedad vascular cerebral (EVC), una de las principales causas de discapacidad a nivel mundial. A pesar de que diversos grupos han reportado la eficacia de estos sistemas, no se ha logrado un consenso sobre su verdadero potencial. Por esta razón, una revisión de la evaluación reciente de las BCI para rehabilitación del miembro superior en la EVC es presentado desde la perspectiva de analizar diferencias y similitudes entre las variables reportadas en los estudios. En la esta revisión se incluyeron estudios clínicos y pilotos con un grupo control. La mayor parte de los estudios utilizaron sistemas robóticos como retroalimentación, seguido por estimulación eléctrica neuromuscular y retroalimentación visual. En comparación con otras terapias experimentales, los efectos de intervenciones con BCI se han reportado en pocos pacientes. Además, la alta variabilidad en el diseño de los estudios, como la etiología de la EVC y la duración de las intervenciones, no permiten comparar los efectos de las terapias BCI. Sin embargo, se puede resaltar una tendencia hacia recuperaciones motoras significativas con BCI, motivando a grupos de investigación a coordinarse de mejor forma para continuar realizando contribuciones al campo.
RESUMEN
Range of motion (ROM) measured objectively in nodal hand osteoarthritis (NHOA) is missing. Evaluation of collateral ligaments by ultrasound (US) is unknown in NHOA also. To compare ROM in interphalangeal joints in housewives with nodal OA, with a control group by a digital system using angle to voltage (Multielgon). The second objective was to assess correlation between collateral radial and ulnar ligaments thickness and ROM. For this cross-sectional observational study, we assessed 60 hands with symptomatic NHOA and 30 hands of healthy housewives matched for age. We obtained clinical and demographic characteristics (a complete standardized physical examination of hand joints, DASH questionnaire, pain surveys, gross grasp hand goniometer, and ROM measurements by Multielgon. Presence of synovitis, power Doppler signal, osteophytes, and collateral ligaments thickness was evaluated by US. We used descriptive statistics, Spearman correlation, X2 test, t test and odds ratio. Significant less gross grasp and ROM in the right hand were observed in NHOA (p = 0.01 for both). Presence of OA, painful joints, disease duration, and score DASH were significant correlated with reduced ROM (OR 4.12, 4.12, 1.04 and 1.09, respectively). Reduced ROM was statistical significant in thumb MCP and IP joints, second and third DIP in dominant hand. There was no association between collateral radial and ulnar ligaments and reduced ROM. Synovitis and osteophytes were more prevalent in OA group. Multielgon demonstrated the pattern of reduced ROM in nodal OA of housewives particularly in MCP and IP thumb joints, second and third distal interphalangeal joints.