This work presents the design, implementation, and feasibility evaluation of a Motor Imagery (MI) based Brain-Computer Interface (BCI) developed to control a Functional Electrical Stimulation (FES) device. The aim of this system is to assist the upper limb motor recovery of patients with spinal cord injury (SCI). With this BCI-controlled FES system, the user performs open and close MI with either the left or right hand, which if detected is used to provide visual feedback and electroestimulation to muscles in the forearm to perform the corresponding grasping movement. The system was evaluated with seven healthy subjects (HS group) and two SCI patients (SC group) in several experimental sessions across different days. Each experimental session consisted of a training routine devoted to collect calibration EEG data to train the BCI machine learning model, and of a validation routine devoted to validate system in online operation. The online system validation showed an accuracy of the recognition of the MI task that ranged between 78% and 81% for HS participants and between 63% and 93% for SCI participants. Additionally, the time taken by the BCI system to trigger the FES device ranged between 7.05 and 7.29 s for HS participants and between 8.43 s and 13.91 s for SCI participants. Finally, significant negative correlations were observed ( $r=-0.418$ , $p=0.024$ and $r=-0.437$ , $p=0.018$ for left and right hand MI conditions, respectively) between the online BCI performance with a quantitative EEG parameter based on event-related desynchronization/synchronization analysis. The results of this work indicate the feasibility of the proposed BCI coupled to a FES device to be used for SCI patients with a moderate level of disability and provides evidence of the functionality of the proposed BCI system in a motor rehabilitation context.

Background and Objective: Pulsed electromagnetic fields (PEMF) and extracorporeal magnetotransduction therapy (EMTT) have shown promising results in various musculoskeletal disorders; however, substantial heterogeneity in application parameters has hindered the establishment of clear relationships between electromagnetic dosing and clinical response. This systematic review aims to evaluate the safety and effectiveness of PEMF and EMTT therapies for treating chronic musculoskeletal injuries in adults, based on research from 2015 to 2026. By analyzing how specific dosage parameters (such as intensity, frequency, and duration) influence clinical results, the study seeks to establish standardized, evidence-based guidelines for electromagnetic treatment prescriptions. Methods: A systematic review was conducted in accordance with PRISMA 2020 guidelines and prospectively registered in PROSPERO (CRD420251059359). A comprehensive search was performed in PubMed/MEDLINE, CENTRAL, and ScienceDirect for the 2015–2025 period. Randomized clinical trials, quasi-experimental studies, and case reports were included. Study selection, data extraction, and risk of bias assessment were performed by two independent reviewers using RoB 2, ROBINS-I, and Joanna Briggs Institute checklists. Results were synthesized narratively following SWiM (Synthesis Without Meta-analysis) recommendations. Results: Twenty-eight studies (1060 participants) were included. A dosimetric dichotomy emerged: high-intensity protocols with rapid field variation rates (e.g., EMTT > 60 kT/s) were consistently associated with robust improvements in structural and mechanically driven pathologies. Conversely, low-intensity protocols (e.g., <5 mT) often yielded results indistinguishable from placebo or active controls, particularly in nociplastic pain conditions. Quantitative analysis indicated that in structural pathologies, functional gains were maintained or amplified post-treatment, whereas nociplastic conditions showed potential symptom recurrence. No serious adverse events were reported, confirming a favorable safety profile. Conclusions: PEMF and EMTT are promising adjunctive therapies for musculoskeletal disorders, with efficacy appearing sensitive to electromagnetic dosimetry. However, significant methodological heterogeneity and the use of combination therapies limit these findings to exploratory trends. The lack of standardized safety reporting and technical parameters (e.g., waveform, dB/dt) underscores a critical translational gap. Future research must prioritize rigorous, standardized randomized controlled trials to establish definitive, evidence-based therapeutic recommendations.