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SYSTEMATIC REVIEW article

Front. Neurol.

Sec. Neurorehabilitation

This article is part of the Research TopicNew approaches for central nervous system rehabilitation - Volume IIView all 15 articles

Effects of Brain-Computer Interface-Based Rehabilitation on Lower Limb Function and Activities of Daily Living after Stroke: A Systematic Review and Meta-Analysis

Provisionally accepted
Changshuo  LiuChangshuo Liu1Jiaxu  HanJiaxu Han1Yuhui  WangYuhui Wang1Xinyun  LiangXinyun Liang1Xianguo  MengXianguo Meng1,2*
  • 1Shandong First Medical University - Tai'an Campus, Tai'an, China
  • 2Shandong Provincial Qianfoshan Hospital, Jinan, China

The final, formatted version of the article will be published soon.

Background: Lower limb motor dysfunction is a common sequela of stroke that significantly impacts patients' walking safety and independence in daily living. Although brain-computer interface (BCI) technology has demonstrated efficacy in upper limb rehabilitation, its effects on lower limb recovery have not yet been systematically evaluated. Methods: A systematic literature search was conducted across seven databases (PubMed, Web of Science, Embase, China National Knowledge Infrastructure, SinoMed, VIP Database, and Wanfang Data.) to identify studies investigating BCI for post-stroke lower limb dysfunction, encompassing records published up to September 2025. All statistical analyses were performed using Review Manager software (version 5.4.1). Results: Thirteen studies involving 582 participants were included. BCI training significantly improved the scores of Fugl-Meyer Assessment for Lower Extremity (FMA-LE, MD = 2.67, 95%CI: 2.31-3.03, P < 0.00001, I² = 0%) , Berg Balance Scale (BBS, MD = 7.04, 95%CI: 3.14-10.94, P = 0.0004), and Modified Barthel Index (MBI, MD = 6.72, 95%CI: 1.74-11.69, P = 0.008). Furthermore, a single study reported significant improvement in functional mobility measured by the Timed Up and Go Test (TUGT). Subgroup analysis for activities of daily living MBI showed that a cumulative training time of ≥500 minutes was associated with greater improvement. Conclusion: BCI-based training is an effective approach for improving lower limb recovery after stroke, demonstrating benefits in motor function, balance, and functional mobility. While evidence for certain outcomes remains limited, the dose-dependent effect on daily living activities underscores the importance of sufficient training duration. Future research should validate these findings and clarify effects across a broader range of functional measures.

Keywords: activities ofdaily living, Brain-Computer Interfaces, lower limb, Meta-analysis, Motor function, Stroke

Received: 15 Nov 2025; Accepted: 09 Feb 2026.

Copyright: © 2026 Liu, Han, Wang, Liang and Meng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Xianguo Meng

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