Graded multisensory neurofeedback via the iNems system for comprehensive upper limb recovery after stroke: a multiple baseline study

All four participants improved on at least some movement and body-perception measures during adaptive training. The small design is useful for early testing, but it is far too small to predict benefit for other stroke survivors.

Kodama T, Kitai K, Mizomoto Y, Nishigaya K, Hashimoto S, Hiraga R, Shimizu S, Kawabata M, Hirabayashi Y, Ikesue K, Kako H, Yasui S, Ito H, Nishimoto K, Katayama O, Yamaguchi H, Nagano H, Inoue M, Murata S, Morita K.
Frontiers in Human Neuroscience · Publication date: 2026-10-07
Added to site: 2026-10-10
DOI: 10.3389/fnhum.2026.1938622

Published October 7, 2026. Added to Neurofeedback.com October 10, 2026 after full-text review.

Modalities

EEG neurofeedback, Brain-computer interface rehabilitation

Clinical focus

Post-stroke upper-limb recovery, Graded multisensory feedback

Population

Adults two to five months after stroke with upper-limb motor and sensory impairment

Sample

Four participants, ages 35 to 88

Intervention / method

A random-feedback baseline phase followed by adaptive iNems training that used sensorimotor EEG event-related desynchronization to scale visual and electrical feedback across three individualized intensity levels

Comparator

Within-participant random-feedback baseline phase

Clinician summary

FMA-UE gains ranged from 6 to 16 points. Integrated effects were large for Box and Block performance (Tau-U 0.75), agency (0.80), ownership (0.89) and numbness in affected cases (-0.85). The online trigger rate averaged 78.8% during motor-imagery trials, but rest-trial false positives were not systematically assessed.

How to interpret the findings

Only four heterogeneous participants were studied without a parallel control group or blinded outcome assessment. Baseline duration varied, real-time classification specificity was not established, mechanistic interpretations were post hoc in places, and the study cannot separate natural recovery, concurrent rehabilitation, expectation or repeated testing from intervention effects. Larger randomized trials are needed.

Equipment and disclosures

The source reports an OpenBCI eight-channel EEG system, a Burning Shaper BR-5100 electrical stimulation device and an LCD monitor. This factual study-equipment description is not an endorsement and the editorial artwork does not reproduce the hardware.

Supported by the Japan Society for the Promotion of Science. One author was employed by Watanabe Hospital and one by CARETECH Plus Inc.; the remaining authors declared no commercial or financial relationships that could be construed as conflicts.

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