Neurological disorders represent a growing global health burden requiring long-term, interdisciplinary rehabilitation. Computational neurorehabilitation (compNR) - the use of data-driven and model-based approaches to personalize treatment - offers new opportunities for precision rehabilitation. However, its clinical deployment is limited by fragmented data systems, poor interoperability, and low clinician engagement in model development. We embed the learning health system (LHS) framework in Neurorehabilitation through integration of multimodal data collection, model computation, and clinical visualization that enables clinician-ML collaboration in everyday neurorehabilitation practice. The system facilitates structured digital data capture, secure computational processing, and interoperable visualization of patient trajectories. Through a real-world deployment in stroke rehabilitation, we demonstrate how such an infrastructure bridges the gap between research models and clinical use, showcasing one approach to a translational pathway for compNR.
A significant and rising proportion of the global population suffer from non-communicable diseases, such as neurological disorders. Neurorehabilitation aims to restore function and independence of neurological patients through providing interdisciplinary therapeutic interventions. Computational neurorehabilitation, an automated simulation approach to dynamically optimize treatment effectivity, is a promising tool to ensure that each patient has the best therapy for their current status. However, computational neurorehabilitation relies on integrated data flows between clinical assessments, predictive models, and healthcare professionals. Current neurorehabilitation practice is limited by low levels of digitalization and low data interoperability. We here propose and demonstrate an embedded intelligent health system that enables detailed digital data collection in a modular fashion, real-time data flows between patients, models, and clinicians, clinical integration, and multi-context capacities, as required for computational neurorehabilitation approaches. We give an outlook on how modern exploratory data analysis tools can be integrated to facilitate model development and knowledge
Individuals with diverse motor abilities often benefit from intensive and specialized rehabilitation therapies aimed at enhancing their functional recovery. Nevertheless, the challenge lies in the restricted availability of neurorehabilitation professionals, hindering the effective delivery of the necessary level of care. Robotic devices hold great potential in reducing the dependence on medical personnel during therapy but, at the same time, they generally lack the crucial human interaction and motivation that traditional in-person sessions provide. To bridge this gap, we introduce an AI-based system aimed at delivering personalized, out-of-hospital assistance during neurorehabilitation training. This system includes a rehabilitation training device, affective signal classification models, training exercises, and a socially interactive agent as the user interface. With the assistance of a professional, the envisioned system is designed to be tailored to accommodate the unique rehabilitation requirements of an individual patient. Conceptually, after a preliminary setup and instruction phase, the patient is equipped to continue their rehabilitation regimen autonomously in the comfor
Neurorehabilitation conventionally relies on the interaction between a patient and a physical therapist. Robotic systems can improve and enrich the physical feedback provided to patients after neurological injury, but they under-utilize the adaptability and clinical expertise of trained therapists. In this position paper, we advocate for a novel approach that integrates the therapist's clinical expertise and nuanced decision-making with the strength, accuracy, and repeatability of robotics: Robot-mediated physical Human-Human Interaction. This framework, which enables two individuals to physically interact through robotic devices, has been studied across diverse research groups and has recently emerged as a promising link between conventional manual therapy and rehabilitation robotics, harmonizing the strengths of both approaches. This paper presents the rationale of a multidisciplinary team-including engineers, doctors, and physical therapists-for conducting research that utilizes: a unified taxonomy to describe robot-mediated rehabilitation, a framework of interaction based on social psychology, and a technological approach that makes robotic systems seamless facilitators of natu
Neurological injuries and age-related decline can impair sensory processing and disrupt motor coordination, gait, and balance. As mechanisms of neuroplasticity have become better understood, vibration-based interventions have gained attention as potential tools to stimulate sensory pathways and motor circuits to support functional recovery. This survey reviews stochastic and resonant vibration modalities, describing their mechanisms, therapeutic rationales, and clinical applications. We synthesize evidence on whole-body vibration for improving balance, mobility, and fine motor function in aging adults, stroke survivors, and individuals with Parkinson's disease, with attention to challenges in parameter optimization, generalizability, and safety. We also assess recent developments in focused muscle vibration and wearable stochastic resonance devices for upper-limb rehabilitation, evaluating their clinical promise along with limitations in scalability, ecological validity, and standardization. Across these modalities, we identify key variables that shape therapeutic outcomes and highlight ongoing efforts to refine protocols, improve usability, and integrate vibration techniques into
Wearable egocentric cameras and machine learning have the potential to provide clinicians with a more nuanced understanding of patient hand use at home after stroke and spinal cord injury (SCI). However, they require detailed contextual information (i.e., activities and object interactions) to effectively interpret metrics and meaningfully guide therapy planning. We demonstrate that an object-centric approach, focusing on what objects patients interact with rather than how they move, can effectively recognize Activities of Daily Living (ADL) in real-world rehabilitation settings. We evaluated our models on a complex dataset collected in the wild comprising 2261 minutes of egocentric video from 16 participants with impaired hand function. By leveraging pre-trained object detection and hand-object interaction models, our system achieves robust performance across different impairment levels and environments, with our best model achieving a mean weighted F1-score of 0.78 +/- 0.12 and maintaining an F1-score > 0.5 for all participants using leave-one-subject-out cross validation. Through qualitative analysis, we observe that this approach generates clinically interpretable informatio
In today's world, many patients with cognitive impairments and motor dysfunction seek the attention of experts to perform specific conventional therapies to improve their situation. However, due to a lack of neurorehabilitation professionals, patients suffer from severe effects that worsen their condition. In this paper, we present a technological approach for a novel robotic neurorehabilitation training system. It relies on a combination of a rehabilitation device, signal classification methods, supervised machine learning models for training adaptation, training exercises, and socially interactive agents as a user interface. Together with a professional, the system can be trained towards the patient's specific needs. Furthermore, after a training phase, patients are enabled to train independently at home without the assistance of a physical therapist with a socially interactive agent in the role of a coaching assistant.
Assessing the quality of movements for post-stroke patients during the rehabilitation phase is vital given that there is no standard stroke rehabilitation plan for all the patients. In fact, it depends basically on the patient's functional independence and its progress along the rehabilitation sessions. To tackle this challenge and make neurorehabilitation more agile, we propose an automatic assessment pipeline that starts by recognizing patients' movements by means of a shallow deep learning architecture, then measuring the movement quality using jerk measure and related measures. A particularity of this work is that the dataset used is clinically relevant, since it represents movements inspired from Fugl-Meyer a well common upper-limb clinical stroke assessment scale for stroke patients. We show that it is possible to detect the contrast between healthy and patients movements in terms of smoothness, besides achieving conclusions about the patients' progress during the rehabilitation sessions that correspond to the clinicians' findings about each case.
As life expectancy is mostly increasing, the incidence of many neurological disorders is also constantly growing. For improving the physical functions affected by a neurological disorder, rehabilitation procedures are mandatory, and they must be performed regularly. Unfortunately, neurorehabilitation procedures have disadvantages in terms of costs, accessibility and a lack of therapists. This paper presents Immersive Neurorehabilitation Exercises Using Virtual Reality (INREX-VR), our innovative immersive neurorehabilitation system using virtual reality. The system is based on a thorough research methodology and is able to capture real-time user movements and evaluate joint mobility for both upper and lower limbs, record training sessions and save electromyography data. The use of the first-person perspective increases immersion, and the joint range of motion is calculated with the help of both the HTC Vive system and inverse kinematics principles applied on skeleton rigs. Tutorial exercises are demonstrated by a virtual therapist, as they were recorded with real-life physicians, and sessions can be monitored and configured through tele-medicine. Complex movements are practiced in g
The relationship between brain lateralization and cognitive functions is well-documented. The left hemisphere primarily handles tasks such as language and arithmetic, while the right hemisphere is involved in creative activities like drawing and music perception. Eye-tracking technology has shown the potential to reveal cognitive states by measuring ocular metrics such as pupil diameter and fixation duration. However, the ability to distinguish lateralized brain activity using these ocular metrics remains underexplored. Here, we demonstrate that pupil diameter and fixation duration can effectively classify left and right brain hemisphere activities. We obtained a considerably high classification performance, with an F1 score of 0.894. The results suggest that ocular metrics are robust indicators of lateralized brain activity and can be applied in cognitive monitoring and neurorehabilitation. Our future work expands on this by integrating these methods into real-time applications EyeBrain, potentially broadening their use across various cognitive and neurological domains.
Brain-computer interfaces (BCIs) have opened new platforms for human-computer interaction, medical diagnostics, and neurorehabilitation. Wearable BCI systems, which typically employ non-invasive electrodes for portable monitoring, hold great promise for real-world applications, but also face significant challenges of signal quality degradation caused by motion artifacts and environmental interferences. Most existing wearable BCI datasets are collected under stationary or controlled lab settings, limiting their utility for evaluating performance under body movement. To bridge this gap, we introduce WearBCI, the first dataset that comprehensively evaluates wearable BCI signals under different motion dynamics with synchronized multimodal recordings (EEG, IMU, and egocentric video), and systematic benchmark evaluations for studying impacts of motion artifact. Specifically, we collect data from 36 participants across different motion dynamics, including body movements, walking, and navigation. This dataset includes synchronized electroencephalography (EEG), inertial measurement unit (IMU) data, and egocentric video recordings. We analyze the collected wearable EEG signals to understand
Continuous brain-computer interfaces (BCIs) that decode motion trajectories from imagined movement offer intuitive motor control, yet how feedback modality and longitudinal training shape neural representations and decoding performance remains poorly understood. We present the first systematic investigation of embodied virtual reality (VR) feedback during real-time 3D virtual limb control driven by motor imagery, across ten longitudinal sessions in ten participants. Performance was evaluated using three strategies: actual online performance (Fixed Decoder Generalisation, FDG), periodic retraining (Sequential Adaptive Training, SAT), and within-session upper-bound estimation (Within-Session Reconstruction, WSR). A CNN-LSTM decoder achieved within-session imagined movement correlations of r = 0.762 under VR and r = 0.672 under screen feedback. VR significantly outperformed screen feedback across all strategies and movement dimensions (improvements of 8.9-13.0%, all p <= 0.002, d = 1.42-2.05). This advantage persisted under fixed decoders without retraining, demonstrating that embodied VR feedback elicits inherently more decodable and generalisable neural representations. Linear mi
Robotic haptic devices combined with virtual reality offer novel opportunities to train fine force generation, an essential yet overlooked component of post-stroke rehabilitation. This study proposes that manipulating the rendered dynamics of tangible virtual objects can be leveraged to train precise force control while engaging the somatosensory system. We conducted an experiment with fifty healthy participants who performed a curling-inspired task in which they had to stretch a virtual spring to generate a target release force to propel the stone to a predefined location on the ice sheet. During training, the spring's force-elongation relationship was modeled as either a linear or non-linear function, i.e., a Gaussian or antisymmetric Gaussian (AS-Gaussian) function with zero derivative at the release target force. Results indicate that the AS-Gaussian group consistently achieved higher force accuracy during training than the linear group, while the Gaussian group only outperformed the linear group toward the end of training. Analysis of personality traits revealed that higher Free Spirit scores were associated with poorer performance and reduced task exploration under Gaussian d
The incorporation of neuroimaging techniques such as electroenchephalography (EEG) and functional near-infrared spectroscopy (fNIRS) has provided new opportunities for the analysis of dynamic brain processes involved in cognitive and motor functions. Despite the great contribution of the open-access neuroimaging datasets to neuroscience studies, they have mainly remained on a single modality and isolated task paradigms performed in a controlled environments. These limitations restrict the analysis of multi-task effects in real-world applications, thus creating a gap in the understanding of how cognitive and motor processes interact in daily life activities. To address these limitations, we present a multi-modal dataset containing neurophysiological (EEG, fNIRS), physiological (ECG), behavioral, and subjective measures collected from 30 healthy participants over three sessions. This dataset includes a hierarchical series of seven tasks ranging from single cognitive and motor activities, such as N-back, motor, passive motor, mental arithmetic and motor imagery, to combined cognitive-motor interactions simulating real life scenarios. This raw dataset provides a resource for developing
Brain-computer interfaces (BCIs) enable direct communication between the brain and external devices, providing critical support for individuals with motor impairments. However, accurate motor imagery (MI) decoding from electroencephalography (EEG) remains challenging due to noise and cross-session variability. This study introduces EEG-MFTNet, a novel deep learning model based on the EEGNet architecture, enhanced with multi-scale temporal convolutions and a Transformer encoder stream. These components are designed to capture both short and long-range temporal dependencies in EEG signals. The model is evaluated on the SHU dataset using a subject-dependent cross-session setup, outperforming baseline models, including EEGNet and its recent derivatives. EEG-MFTNet achieves an average classification accuracy of 58.9% while maintaining low computational complexity and inference latency. The results highlight the model's potential for real-time BCI applications and underscore the importance of architectural innovations in improving MI decoding. This work contributes to the development of more robust and adaptive BCI systems, with implications for assistive technologies and neurorehabilita
Human intention detection with hand motion prediction is critical to drive the upper-extremity assistive robots in neurorehabilitation applications. However, the traditional methods relying on physiological signal measurement are restrictive and often lack environmental context. We propose a novel approach that predicts future sequences of both hand poses and joint positions. This method integrates gaze information, historical hand motion sequences, and environmental object data, adapting dynamically to the assistive needs of the patient without prior knowledge of the intended object for grasping. Specifically, we use a vector-quantized variational autoencoder for robust hand pose encoding with an autoregressive generative transformer for effective hand motion sequence prediction. We demonstrate the usability of these novel techniques in a pilot study with healthy subjects. To train and evaluate the proposed method, we collect a dataset consisting of various types of grasp actions on different objects from multiple subjects. Through extensive experiments, we demonstrate that the proposed method can successfully predict sequential hand movement. Especially, the gaze information show
This study presents a real-time, portable brain-computer interface (BCI) system designed to support hand rehabilitation for stroke patients. The system combines a low cost 3D-printed robotic exoskeleton with an embedded controller that converts brain signals into physical hand movements. EEG signals are recorded using a 14-channel Emotiv EPOC+ headset and processed through a supervised convolutional autoencoder (CAE) to extract meaningful latent features from single-trial data. The model is trained on publicly available EEG data from healthy individuals (WAY-EEG-GAL dataset), with electrode mapping adapted to match the Emotiv headset layout. Among several tested classifiers, Ada Boost achieved the highest accuracy (89.3%) and F1-score (0.89) in offline evaluations. The system was also tested in real time on five healthy subjects, achieving classification accuracies between 60% and 86%. The complete pipeline - EEG acquisition, signal processing, classification, and robotic control - is deployed on an NVIDIA Jetson Nano platform with a real-time graphical interface. These results demonstrate the system's potential as a low-cost, standalone solution for home-based neurorehabilitation.
Brain-computer interfaces (BCI) in electroencephalography (EEG)-based motor imagery classification offer promising solutions in neurorehabilitation and assistive technologies by enabling communication between the brain and external devices. However, the non-stationary nature of EEG signals and significant inter-subject variability cause substantial challenges for developing robust cross-subject classification models. This paper introduces a novel Spatial-Spectral-Temporal Attention Fusion (SSTAF) Transformer specifically designed for upper-limb motor imagery classification. Our architecture consists of a spectral transformer and a spatial transformer, followed by a transformer block and a classifier network. Each module is integrated with attention mechanisms that dynamically attend to the most discriminative patterns across multiple domains, such as spectral frequencies, spatial electrode locations, and temporal dynamics. The short-time Fourier transform is incorporated to extract features in the time-frequency domain to make it easier for the model to obtain a better feature distinction. We evaluated our SSTAF Transformer model on two publicly available datasets, the EEGMMIDB dat
Hybrid assistive systems that integrate functional electrical stimulation (FES) and robotic exoskeletons offer a promising approach for neurorehabilitation. However, control of these systems remains challenging due to actuator redundancy and heterogeneous assistive device constraints. This paper introduces a novel cooperative control architecture based on dynamic allocation to address actuator redundancy in a hybrid FES-exoskeleton system. The proposed approach employs a modular control allocator that redistributes required control torques between FES and exoskeleton actuators in real time, accounting for device-specific limitations and user preferences (e.g., prioritizing one assistive device over another). Within this framework, the high-level controller determines the total assistance level, while the allocator dynamically distributes control effort based on these assistive device-specific considerations. Simulation results and experimental validation demonstrate the method's effectiveness in resolving actuator redundancy in the FES-exoskeleton system while reflecting actuator constraints, indicating its potential for deployment in clinical studies to assess patient acceptance a
Motor imagery (MI) based brain-computer interfaces (BCIs) hold significant potential for assistive technologies and neurorehabilitation. However, the precise and efficient decoding of MI remains challenging due to their non-stationary nature and low signal-to-noise ratio. This paper introduces a novel end-to-end deep learning framework of Discriminative Residual Dense Convolutional Autoencoder with Spatio-Temporal Graph Neural Network (DRDCAE-STGNN) to enhance the MI feature learning and classification. Specifically, the DRDCAE module leverages residual-dense connections to learn discriminative latent representations through joint reconstruction and classifica-tion, while the STGNN module captures dynamic spatial dependencies via a learnable graph adjacency matrix and models temporal dynamics using bidirectional long short-term memory (LSTM). Extensive evaluations on BCI Competition IV 2a, 2b, and PhysioNet datasets demonstrate state-of-the-art performance, with average accuracies of 95.42%, 97.51%, and 90.15%, respectively. Ablation studies confirm the contribution of each component, and interpreta-bility analysis reveals neurophysiologically meaningful connectivity patterns. More