{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T10:00:59Z","timestamp":1780912859168,"version":"3.54.1"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Severe upper limb motor impairment is one of the most disabling consequences of stroke. Although brain-controlled rehabilitation technologies, such as brain\/neural exoskeletons (B\/NE), have been shown to be effective in promoting motor recovery, their clinical adoption remains limited because of insufficient integration of B\/NE into existing clinical workflows. Here, we introduce and validate a fully portable B\/NE system that overcomes this limitation by relying on brain (electroencephalography) and ocular (electrooculography) signals to restore bimanual activities of daily living within a novel therapeutic framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>In this pilot study, we tested the feasibility of the novel approach in 5 stroke survivors (mean age, 51 years; SD=14.8) undergoing inpatient neurorehabilitation. Stroke survivors aged 18 to 80 years, who exhibited hemiparesis and sufficient cognitive ability to understand and follow instructions, were invited to participate in a 1-hour training session. This session included system setup and calibration, followed by performing B\/NE\u2013supported, self-paced bimanual activities of daily living. As primary outcome measures, we assessed control accuracy, the ability to reliably modulate electroencephalography and electrooculography signals, and time to initialize, defined as the time required to react to cues and initiate the task, serving as a measure of control intuitiveness. In addition, participants\u2019 B\/NE control performance during assisted training of bimanual activities of daily living, as well as setup preparation time, were assessed via direct observation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>Participants demonstrated reliable control accuracy in using both brain (mean, 83%; SD=15.36) and ocular (mean=100%) signals, as well as intuitive control (time to initialize &lt;2 s). All participants reliably controlled the B\/NE performing a battery of 10 bimanual activities of daily living. Moreover, setup and calibration times remained below 20 minutes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>These findings highlight the compatibility of the novel B\/NE with existing clinical workflows and its feasibility to enable B\/NE\u2013supported stroke neurorehabilitation by facilitating seamless integration into clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/strokeaha.125.052008","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T10:00:44Z","timestamp":1763373644000},"page":"505-510","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Hybrid Brain\/Neural Exoskeleton Enables Bimanual ADL Training in Routine Stroke Rehabilitation"],"prefix":"10.1161","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-9857-4428","authenticated-orcid":true,"given":"Annalisa","family":"Colucci","sequence":"first","affiliation":[{"name":"Clinical Neurotechnology Laboratory, Department of Psychiatry and Neurosciences, Charit\u00e9 Campus Mitte (CCM), Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Germany (A.C., M.V., C.A., N.P., S.R.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mareike","family":"Vermehren","sequence":"additional","affiliation":[{"name":"Clinical Neurotechnology Laboratory, Department of Psychiatry and Neurosciences, Charit\u00e9 Campus Mitte (CCM), Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Germany (A.C., M.V., C.A., N.P., S.R.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4268-6708","authenticated-orcid":true,"given":"Cornelius","family":"Angerh\u00f6fer","sequence":"additional","affiliation":[{"name":"Clinical Neurotechnology Laboratory, Department of Psychiatry and Neurosciences, Charit\u00e9 Campus Mitte (CCM), Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Germany (A.C., M.V., C.A., N.P., S.R.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niels","family":"Peekhaus","sequence":"additional","affiliation":[{"name":"Clinical Neurotechnology Laboratory, Department of Psychiatry and Neurosciences, Charit\u00e9 Campus Mitte (CCM), Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Germany (A.C., M.V., C.A., N.P., S.R.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1199-5707","authenticated-orcid":true,"given":"Won-Seok","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea (W.-S.K., W.K.C., N.-J.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9756-6817","authenticated-orcid":true,"given":"Won Kee","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea (W.-S.K., W.K.C., N.-J.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8449-8681","authenticated-orcid":true,"given":"Volker","family":"H\u00f6mberg","sequence":"additional","affiliation":[{"name":"Department of Neurorehabilitation, SRH Gesundheitszentrum Bad Wimpfen GmbH, Germany (V.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5193-8678","authenticated-orcid":true,"given":"Nam-Jong","family":"Paik","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea (W.-S.K., W.K.C., N.-J.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1280-5538","authenticated-orcid":true,"given":"Surjo R.","family":"Soekadar","sequence":"additional","affiliation":[{"name":"Clinical Neurotechnology Laboratory, Department of Psychiatry and Neurosciences, Charit\u00e9 Campus Mitte (CCM), Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Germany (A.C., M.V., C.A., N.P., S.R.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001123"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.772199"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.544"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.23879"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2021.766879"},{"key":"e_1_3_3_7_2","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1007\/978-3-030-05668-1_5","volume-title":"Brain-Computer Interface Research, A State-of-the-Art Summary 7","author":"Soekadar SR","year":"2019","unstructured":"Soekadar SR, Nann M, Crea S, Trigili E, G\u00f3mez C, Opisso E, Cohen LG, 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Restoration of finger and arm movements using hybrid brain\/neural assistive technology in everyday life environments. In: Christoph Guger NMK, Allison BZ, eds. Brain-Computer Interface Research, A State-of-the-Art Summary 7. Springer International Publishing; 2019:53\u201361."},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/15459683221138751"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1038\/s44222-024-00185-2"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnhum.2024.1429130"},{"key":"e_1_3_3_11_2","first-page":"54","article-title":"Rehabilitation after stroke: practicable functionalities and benefiting patients of brain-computer interfaces in combination with functional electrical stimulation\u2014a qualitative interview study.","volume":"10","author":"Wetzel D","year":"2022","unstructured":"Wetzel D, Winterlich J, Schaal T. 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EEG-EMG based hybrid brain computer interface for triggering hand exoskeleton for neuro-rehabilitation. Paper presented at: 3rd International Conference on Advances in Robotics. 2017. doi: 10.1145\/3132446.3134909","DOI":"10.1145\/3132446.3134909"},{"key":"e_1_3_3_30_2","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1007\/978-3-031-26801-4_5","volume-title":"Policy, Identity, and Neurotechnology: The Neuroethics of Brain-Computer Interfaces","author":"Soekadar SR","year":"2023","unstructured":"Soekadar SR, Vermehren M, Colucci A, Haslacher D, Bublitz C, Ienca M, Chandler JA, Blankertz B. Future developments in brain\/neural\u2013computer interface technology. In: Dubljevi\u0107 V, Coin A, eds. Policy, Identity, and Neurotechnology: The Neuroethics of Brain-Computer Interfaces. Springer International Publishing; 2023:65\u201385."}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.125.052008","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T19:00:51Z","timestamp":1769454051000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.125.052008"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":29,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1161\/STROKEAHA.125.052008"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.125.052008","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2]]},"assertion":[{"value":"2025-04-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-14","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}