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Review
. 2023 Dec 17;11(24):3189.
doi: 10.3390/healthcare11243189.

Effectiveness of the Combined Use of a Brain-Machine Interface System and Virtual Reality as a Therapeutic Approach in Patients with Spinal Cord Injury: A Systematic Review

Amaranta De Miguel-Rubio  1 , Ignacio Gallego-Aguayo  1 , Maria Dolores De Miguel-Rubio  2 , Mariana Arias-Avila  3 , David Lucena-Anton  4 , Alvaro Alba-Rueda  1
Affiliations
Review

Effectiveness of the Combined Use of a Brain-Machine Interface System and Virtual Reality as a Therapeutic Approach in Patients with Spinal Cord Injury: A Systematic Review

Amaranta De Miguel-Rubio et al. Healthcare (Basel). .

Abstract

Spinal cord injury has a major impact on both the individual and society. This damage can cause permanent loss of sensorimotor functions, leading to structural and functional changes in somatotopic regions of the spinal cord. The combined use of a brain-machine interface and virtual reality offers a therapeutic alternative to be considered in the treatment of this pathology. This systematic review aimed to evaluate the effectiveness of the combined use of virtual reality and the brain-machine interface in the treatment of spinal cord injuries. A search was performed in PubMed, Web of Science, PEDro, Cochrane Central Register of Controlled Trials, CINAHL, Scopus, and Medline, including articles published from the beginning of each database until January 2023. Articles were selected based on strict inclusion and exclusion criteria. The Cochrane Collaboration's tool was used to assess the risk of bias and the PEDro scale and SCIRE systems were used to evaluate the methodological quality of the studies. Eleven articles were selected from a total of eighty-two. Statistically significant changes were found in the upper limb, involving improvements in shoulder and upper arm mobility, and weaker muscles were strengthened. In conclusion, most of the articles analyzed used the electroencephalogram as a measurement instrument for the assessment of various parameters, and most studies have shown improvements. Nonetheless, further research is needed with a larger sample size and long-term follow-up to establish conclusive results regarding the effect size of these interventions.

Keywords: brain–computer interfaces; rehabilitation; spinal cord injuries; virtual reality.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of the selection process of the systematic review following the PRISMA recommendations [30].
Figure 2
Figure 2
Risk of bias of the studies included in the systematic review. The green circle (+) indicates low risk of bias, the yellow circle (?) unclear risk of bias, and the red circle (-) high risk of bias [11,35,36,37,38,39,40,41,42,43,44].
Figure 3
Figure 3
Overall risk of bias, with each category presented as percentages.
See this image and copyright information in PMC

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