Navigation paradigms for non-invasive BCI-controlled wheelchairs: a systematic review

Clinical Snapshot

Key Findings

• Effect Size: Not applicable - qualitative systematic review

• Primary Outcome: Classification of BCI wheelchair navigation paradigms into BCI-based (20 studies) and wheelchair-based (27 studies) approaches

• Nnt Or Sensitivity: Quality assessment scores ranged 40-95% with 40% of studies showing low risk of bias

• Confidence Interval: Not reported

Clinical Application

Currently limited to research settings; real-world implementation requires significant technological advancement Relevant to NDIS participants requiring assistive technology; potential future PBS consideration for advanced wheelchair systems pending clinical validation Individuals with severe motor impairments from neurological conditions requiring powered wheelchair assistance

Abstract

Brain-controlled powered wheelchairs represent a promising advancement for individuals with neurological conditions that significantly impair motor function. Despite substantial progress, brain-controlled wheelchairs have not been adapted for real-world settings. This article systematically reviews recent trends in brain-computer interface (BCI) technology for wheelchair navigation and control, highlighting the contributions and limitations of various navigation paradigms. The review was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, sourcing studies from four databases (PubMed, Scopus, IEEE Xplore, Google Scholar) published between 2000 and April 2025. It focused on non-invasive BCI paradigms and real-world navigation experiments. The results were narratively synthesized and classified into two primary categories: BCI-based navigation paradigms and wheelchair-based navigation paradigms, along with intersecting concepts such as single-variant BCI, hybrid BCI, control switches, and proportional control. Of the 149 full-text articles reviewed, 47 were included and categorized by navigation paradigm, comprising 20 BCI-based and 27 wheelchair-based studies, with 6 involving participants with motor disabilities. Quality assessment scores ranged from 40% to 95%, with approximately 40% of the studies demonstrating a low risk of bias. The findings indicate that low-level navigation control was predominant in BCI wheelchair studies, with 31 studies employing minimal or no obstacle avoidance. Most studies (57%) integrated sensors for obstacle avoidance, localization, mapping, and autonomous navigation. Twenty-two studies utilized control switches, and five incorporated proportional control for wheelchair navigation. Additionally, motor imagery and steady-state visually evoked potential paradigms have emerged as the most common approaches for generating control commands, highlighting their potential for effective navigation. Given the potential societal impact on a large number of individuals, future research should prioritize enhancing the reliability and adaptability of BCI wheelchair systems in real-world environments.

References

1. 1.Ukaegbu, U. F., Houshmand, S., Hammond, L., Adams, K., Andersen, J., & Rouhani, H. (2026). Navigation paradigms for non-invasive BCI-controlled wheelchairs: a systematic review. Progress in Biomedical Engineering, Article ae5563. https://doi.org/10.1088/2516-1091/ae5563