ABSTRACT

INTRODUCTION. The use of neurotechnology, the brain–computer interface (BCI), based on the motor imagery (MI), occupies one of the leading places in terms of effectiveness in neurorehabilitation. At the same time, various types of feedback in the BCI system are being developed and actively used in the rehabilitation process. The feedback targets the visual, proprioceptive, or auditory sensory system, and may employ a multimodal approach depending on the rehabilitation paradigm. Much attention of researchers is attracted to using touch, sensation of touch, force, and vibration as reinforcement signals via haptic feedback technology AIM. To evaluate the effectiveness of the integration of haptic biofeedback into BCI technology in patients with arm paresis in the recovery period after a stroke.

MATERIALS AND METHODS. Eighteen patients suffering from chronic stroke (5 females and 13 males) participated in the study. The patients participated in motor imagery BCI trainings and were split into two groups according to the feedback type. The first group (9 patients, age 59,2 ± 10,6, time since stroke 10,4 ± 2,3 month) received haptic feedback via vibrating stimulation of palm surface and the second group (9 patients, age 59,2 ± 10,6, time since stroke 12 ± 9,8 month) received proprioceptive feedback via palm opening actuation with a robotic actuator. All patients received pharmacological therapy as part of secondary stroke prevention; rehabilitation interventions included therapeutic exercise, physiotherapy procedures, massage, and speech therapy sessions. 

RESULTS AND DISCUSSION. In group 1, motor function improved according to the Fugl-Meyer (FM), ARAT scales from 18 [14; 24] to 30 [20;30], with 2[1; 5] 3 [2; 8] points, respectively. In the 2nd group from 20 [17; 23] to 23[19; 27] on the FM scale, from 2 [1; 6] to 4 [3; 8] points on the ARAT scale. If we consider the 1st group as a "case" and the 2nd as a "control", then after adjusting for the initial FM (ANCOVA), we obtained a difference in the indicator (Δ) of the FM scale of 3.2 points (p = 0.046). The data obtained also demonstrates that BCI with vibrating rings is superior to BCI controlled by an exoskeleton in restoring motor functions, even with a pairwise comparison of similar patients.

CONCLUSION. The use of BCI technology based on MI in combination with biofeedback in the form of vibration stimulation of the palm surfaces of the hands is a new promising method of rehabilitation of patients with severe hemiparesis after a stroke.

KEYWORDS: brain–computer interface, biofeedback, exoskeleton, vibrational stimulation, rehabilitation after stroke, post-stroke hemiparesis 

For citation: Kotov S.V., Kondur A.A., Slyunkova E.V., Bobrov P.D., Bobrov D.A., Gabuzov G.G., Lukyanov E.S., Shagin D.A. The Effectiveness of a Non-Invasive Brain-Computer Interface Combined with Hand Vibration Stimulation in the Rehabilitation of Patients with Severe Post-Stroke Paresis. Comorbidity Neurology. 2026; 3 (2): 7–15. https://doi.org/10.62505/3034-185x-2026-3-2-7-15 

*For correspondence: Sergey V. Kotov, Dr. Sci. (Med.), Professor, Head of the Neurology Department, Head of the Neurology Department of the Faculty of Postgraduate Medical Education, Neurologist, M.F. Vladimirsky Moscow Regional Research Clinical Institute, Moscow, Russia, е-mail: kotovsv@yandex.ru.

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ADDITIONAL INFORMATION

Sergey V. Kotov, Dr. Sci. (Med.), Professor, Head of the Neurology Department, Head of the Neurology Department of the Faculty of Postgraduate Medical Education, Neurologist, M.F. Vladimirsky Moscow Regional Research Clinical Institute, Moscow, Russia. E-mail: kotovsv@yandex.ru. ORCID: https://orcid.org/0000-0002-8706-7317

Anna A. Kondur, Ph.D. Sci. (Med.), Senior Researcher at the Neurology Department, Associate Professor of the Neurology Department of the Faculty of Postgraduate Medical Education, Neurologist, M.F. Vladimirsky Moscow Regional Research Clinical Institute, Moscow, Russia. E-mail: annasams@mail.ru. ORCID: https://orcid.org/0000-0003-4646-2895

Elena V. Slyunkova, Ph.D. Sci. (Med.), Researcher at the Neurology Department, Neurologist, M.F. Vladimirsky Moscow Regional Research Clinical Institute, Moscow, Russia. E-mail: elena.zaytsewa@yandex.ru. ORCID: https://orcid.org/0000-0002-6933-5437

Pavel D. Bobrov, Ph.D. Sci. (Bio.), Senior Researcher, Department of Neurocomputer Interfaces, N.I. Pirogov Russian National Research Medical University, Moscow, Russia. E-mail: bobrov_pd@rsmu.ru. ORCID: https://orcid.org/0000-0003-2566-1043

Dmitry A. Bobrov, Head of the Department of Neurocomputer Interfaces, N.I. Pirogov Russian National Research Medical University, Moscow, Russia. E-mail: bobrov.dmitry@gmail.com. ORCID: https://orcid.org/0000-0003-3077-5416

Grigory G. Gabuzov, Engineer, Department of Neurocomputer Interfaces, N.I. Pirogov Russian National Research Medical University, Moscow, Russia. E-mail: ggabuzov@rambler.ru. ORCID: https://orcid.org/0000-0003-1511-3692

Evgeny S. Lukyanov, Junior Researcher, Department of Neurocomputer Interfaces, N.I. Pirogov Russian National Research Medical University, Moscow, Russia. E-mail: jenialuk@rambler.ru. ORCID: https://orcid.org/0009-0007-5672-1025

Dmitry A. Shagin, Dr. Sci. (Med.), Vice-Rector for Innovation, N.I. Pirogov Russian National Research Medical University, Moscow, Russia. E-mail: shagdim777@gmail.com. ORCID: https://orcid.org/0000-0003-1995-9871

Author contributions. All authors confirm that their authorship complies with the international ICMJE criteria (all authors made a significant contribution to the conception, conduct of the study and the preparation of the article; read and approved the final version before publication). Special contributions: Kotov S.V. – conceptualization; Kotov S.V., Kondur A.A. – methodology; Bobrov P.D., Bobrov D.A., Garbuzov G.G., Lukyanov E.S., Shagin D.A. – software, resources; Kotov S.V., Kondur A.A., Slyunkova E.V., Bobrov P.D., Bobrov D.A. – validation, formal analysis, data curation; Kondur A.A., Slyunkova E.V. – investigation; Kotov S.V., Kondur A.A., Slyunkova E.V., Garbuzov G.G., Lukyanov E.S., Shagin D.A. – writing – original draft; Kotov S.V., Kondur A.A., Slyunkova E.V. – writing, review & editing, visualization; Kotov S.V., Shagin D.A. – supervision, project administration. 

Funding. This study was not supported by any external sources of funding.

Disclosure. The authors declare no apparent or potential conflicts of interest related to the publication of this article. Informed consent for publication. All patients, and if it is impossible to review and sign, persons responsible for the patients (relatives, social workers, etc.) on behalf of the patients undergoing examination and participating in this study, signed informed consent.
 

The content is available under the Creative Commons Attribution 4.0 License.

©2026. Sergey V. Kotov, Anna A. Kondur, Elena V. Slyunkova, Pavel D. Bobrov, Dmitriy A. Bobrov, Grigoriy G. Gabuzov, Evgeniy S. Lukyanov, Dmitriy A. Shagin