Brain-actuated gait trainer with visual and proprioceptive feedback

Objective. Brain-machine interfaces (BMIs) have been proposed in closed-loop applications for neuromodulation and neurorehabilitation. This study describes the impact of different feedback modalities on the performance of an EEG-based BMI that decodes motor imagery (MI) of leg flexion and extension. Approach. We executed experiments in a lower-limb gait trainer (the legoPress) where nine able-bodied subjects participated in three consecutive sessions based on a crossover design. A random forest classifier was trained from the offline session and tested online with visual and proprioceptive feedback, respectively. Post-hoc classification was conducted to assess the impact of feedback modalities and learning effect (an improvement over time) on the simulated trial-based performance. Finally, we performed feature analysis to investigate the discriminant power and brain pattern modulations across the subjects. Main Results. (i) For real-time classification, the average accuracy was 62.33 ± 4.95% and 63.89 ± 6.41% for the two online sessions. The results were significantly higher than chance level, demonstrating the feasibility to distinguish between MI of leg extension and flexion. (ii) For post-hoc classification, the performance with proprioceptive feedback (69.45 ± 9.95%) was significantly better than with visual feedback (62.89 ± 9.20%), while there was no significant learning effect. (iii) We reported individual discriminate features and brain patterns associated to each feedback modality, which exhibited differences between the two modalities although no general conclusion can be drawn. Significance. The study reported a closed-loop brain-controlled gait trainer, as a proof of concept for neurorehabilitation devices. We reported the feasibility of decoding lower-limb movement in an intuitive and natural way. As far as we know, this is the first online study discussing the role of feedback modalities in lower-limb MI decoding. Our results suggest that proprioceptive feedback has an advantage over visual feedback, which could be used to improve robot-assisted strategies for motor training and functional recovery.