Effectiveness of brain-computer interface rehabilitation in stroke patients: A meta-analysis and restricted cubic spline analysis of randomized controlled trials
In brief
Stroke brain-computer training's upper-limb benefit peaked near 48 minutes per session
In a review of 26 randomized trials involving 1,100 stroke patients, brain-computer interface rehabilitation improved scores on several measures of upper-limb movement and function compared with control interventions. A dose-response analysis estimated the greatest upper-limb benefit at about 48 minutes per session, but the clinical importance of the gains and effects on leg function remain uncertain.
- Journal
- Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics (Q1)
- Published
- 30 September 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Yutian Xu, Ping Hu, Zhihui Long, Mingyu Liang, Senlin Du, Yanze Wu, et al.
- PMID
- 42815104
- DOI
- 10.1016/j.neurot.2026.e01086
Why clinicians should know about it
- Picked for Neurology (clinical) (paper of the day, 1 October 2026): BCI rehabilitation meta‑analysis for post‑stroke motor recovery
Abstract
Despite growing evidence supporting the benefits of brain-computer interface (BCI) rehabilitation in post-stroke motor recovery, this review aimed to evaluate its efficacy and determine optimal training intensity. Systematic searches were conducted across Medline, EMBASE and Web of Science from January 1, 1990, to January 30, 2026, to identify relevant RCTs. A random- or fixed-effects model was used to pool outcome data. The restricted cubic spline (RCS) method was applied to estimate the dose-response relationship between BCI training intensity and upper extremity motor function. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool. Twenty-six studies, encompassing 1100 stroke patients, were included in this meta-analysis. The number of studies and participants varied across outcomes. Compared with control interventions, BCI-based rehabilitation demonstrated significant improvement in FMA-UE (24 studies, 1042 participants; MD = 1.11, 95% CI = 0.63 to 1.60), ARAT (8 studies, 524 participants; MD = 0.21, 95% CI = 0.04 to 0.39), WMFT (5 studies, 425 participants; MD = 0.94, 95% CI = 0.32 to 1.55), MBI (4 studies, 153 participants; MD = 1.17, 95% CI = 0.29 to 2.06), and BBS (2 studies, 35 participants; MD = 0.54, 95% CI = 0.02 to 1.07), but not in FMA-LE (2 studies, 78 participants; MD = -0.12, 95% CI = -0.79 to 0.55) or TUGT (2 studies, 35 participants; MD = -0.40, 95% CI = -1.15 to 0.34). Dose-response analysis suggested a non-linear, inverted U-shaped relationship between BCI rehabilitation intensity and FMA-UE, with the peak effect estimated at approximately 48 min per session. BCI-based rehabilitation may be an effective therapeutic strategy for enhancing upper-extremity motor recovery in post-stroke patients, and this review further suggests a potential optimal session duration of approximately 48 min based on dose-response analysis. However, its efficacy for lower-extremity motor recovery remains inconclusive and warrants further investigation.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.