What Holds Back Brain-Computer Interfaces? Uncovering Challenges and Opportunities in BCI-controlled Games for Cerebral Palsy Rehabilitation

2026-06-25

AI Summary

This study addresses the unclear design constraints of brain-computer interfaces (BCIs) in cerebral palsy rehabilitation, particularly the limited understanding of users’ sense of agency and their experience with gameplay-based assistance mechanisms. Integrating insights from clinical therapists and in-depth experiences of ten individuals with cerebral palsy using a BCI-enabled game prototype, the research employs a mixed-methods approach—combining prototyping, clinical observation, and semi-structured interviews—to systematically uncover the tension participants experience between perceived control and algorithmic assistance. Findings reveal that while intermittent gameplay support alleviates training monotony, it concurrently diminishes users’ sense of agency. Therapists acknowledge the potential of BCIs to foster autonomous rehabilitation. The work advocates for BCIs as complementary tools to conventional therapy, facilitating a transition toward self-directed training, and identifies key design challenges and future research directions.

Abstract

Brain-computer interfaces (BCIs) offer promising avenues for cerebral palsy (CP) rehabilitation at home and in the clinic, using games that promote engagement and sustained training effort. Nonetheless, the design constraints of BCI-based CP rehabilitation remain unclear, especially how individuals with CP experience a sense of control through BCI, and how they experience computer-mediated game assistance. To address this gap, we present preliminary clinical and user perspectives on BCI-based CP rehabilitation, drawing on in-clinic insights from a CP therapist and experiential accounts from ten individuals with CP engaging with BCI game prototypes. Sporadic help in BCI games eased monotony, but also fostered doubts regarding agency. The therapist saw BCI rehabilitation as complementary to traditional training, facilitating the transition from playful exercises to autonomous, self-managed training. We outline key challenges and opportunities to inform and empower further design and research of BCI training for CP.

Problem

• Brain-Computer Interface
• Cerebral Palsy
• Rehabilitation
• User Agency
• BCI Games

Innovation

• brain-computer interface
• cerebral palsy rehabilitation
• user agency
• game-based training
• assistive technology