2026-09-08 00:00 United States Clinical Translated from EN

At-Home BCI Therapy Beats Home Exercise for Chronic Stroke Arm Deficits in Randomized Trial

Summary Chronic stroke patients who used an at-home brain-computer interface (BCI) therapy system gained a mean 6.0 points on the Upper Extremity Fugl-Meyer Assessment after 12 weeks, versus 1.5 points for those on a home exercise program. Response rates were 55.5% and 9.6%, for a number needed to treat of 2.2. The trial also exposed the dropout problem in home-based studies: 17 of 42 control participants withdrew because they were dissatisfied with their group assignment.

Why it matters Because both arms trained at home, this randomized trial directly tests whether remote BCI rehabilitation beats current practice, and a number needed to treat of 2.2 means roughly one additional responder for every two patients treated; but with 17 of 42 control participants quitting over their assignment and only 62 patients in the final analysis, the effect may be overstated, and adherence emerges as a real weak point for home-based trials.

BCIwiki (bciwiki.com) — Chronic hemiparetic stroke patients who used an at-home brain-computer interface therapy system for 12 weeks improved upper extremity function significantly more than those assigned to a home exercise program, according to a randomized trial published in Stroke on September 8, 2026 by researchers at Washington University in St. Louis and other institutions.The trial, called BCI-REHAB, compared the at-home BCI therapy system IpsiHand against an at-home exercise program. Participants were aged 18 to 85, had a stroke at least 6 months before enrollment, and had right or left upper extremity paresis or plegia. The intervention group used an EEG-based BCI system coupled to a range-of-motion assist handpiece. Both groups completed 12 weeks of at-home therapy, 5 sessions per week.

The primary outcome was the change in the Upper Extremity Fugl-Meyer Assessment from baseline to 12 weeks. The BCI group improved by a mean 6.0 points (95% CI, 3.9-8.1; P<0.0001), versus 1.5 points in the control group (95% CI, -0.1 to 3.1; P=0.07), with an estimated treatment difference of 4.5 points (95% CI, 1.9-7.1; P=0.0007).

The estimated response rate was 55.5% in the BCI group (95% CI, 33.7%-77.2%) compared with 9.6% in the control group (95% CI, -2.9% to 22.1%), an absolute increase of 45.8% (95% CI, 20.9%-70.8%; P=0.0003) and a number needed to treat of 2.2.

Overall, 109 participants were assessed for eligibility; 85 met the inclusion criteria and were randomized (43 intervention, 42 control). Of the 42 control participants, 17 declined to participate further due to dissatisfaction with study arm assignment. A total of 62 participants were analyzed for the primary outcome (37 intervention, 25 control). The trial is registered as NCT05965713.

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pubmed.ncbi.nlm.nih.gov 2026-09-08

NeuroLutions Neurorehabilitation Stroke Rehabilitation Motor Decoding United States

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2026-08 Kandu's At-Home IpsiHand BCI Improves Arm Function in Chronic Stroke Trial 2023-07 At-home BCI rehab system shows upper-limb gains in completed stroke trial All entries →

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