Clinical Pathway for a Hybrid EMG-EEG BCI for Wheelchair Control in Virtual Reality for Children with Cerebral Palsy

Powered wheelchairs are a valuable tool in the rehabilitation of Activities of Daily Living (ADL) for individuals with motor disabilities. Children with Cerebral Palsy (CP) often experience movement disorders, and physiotherapy is a common rehabilitation method. Modern technologies, such as the development of controlled virtual environments, can accelerate the participant's improvement process. This Thesis aims to assess to evaluate the suitability of the VR-PMP (Virtual Reality Powered Mobility Program) in assessing participant skills during both clinical and home-based training sessions. This can be done in two modalities: immersive and semi-immersive, preceded by an analysis of cybersickness. To ensure the inclusion of all participants with CP, a Brain-Computer Interface (BCI) using electroencephalography (EEG) and electromyography (EMG) signals has been implemented. A validation study was conducted on the VR simulator and its impact on cybersickness among five CP children. Results showed that in addition to exerting lower mental and physical loads during game trials, participants also increased their scores following training. Additionally, the application of VR ensures training safety, provides positive user feedback for enhanced progress, and offers a customizable environment. Subsequently, to include individuals unable to manage controllers or joysticks, a hybrid EEG-EMG BCI was introduced using motor imagery and motor execution paradigms. This pilot study primarily focuses on the feasibility of integrating these two technologies, ensuring compatibility and efficacy. The results from two participants without disabilities demonstrate the implementability of this protocol, selecting suitable movements for all participants and preventing conflicts between the acquisition technologies.