A GRASS-guided phased progressive brain-computer interface approach for post-infarction hand motor recovery.

backgroundHand dysfunction is a disabling sequela of cerebral infarction, often refractory to conventional rehabilitation. Brain–computer interface (BCI) interventions that combine motor imagery (MI) and action observation (AO) demonstrate potential, but heterogeneous reporting restricts evidence synthesis. This article reports a phased progressive BCI protocol guided by the GRASS (Guidelines for Reporting Action Simulation Studies) framework. METHODS AND

resultsA 60‑year‑old male with right hemiparesis following basal ganglia infarction underwent a three‑phase intervention (Central Activation, Reinforcement, and Enhancement) using synchronous AO–MI tasks to trigger a robotic exoskeleton in addition to conventional therapy. Key GRASS elements, including participant details, instructions, and dosage, were transparently reported. After 45 sessions, the Fugl–Meyer Assessment–Upper Extremity score improved from 8/66 to 45/66, the Action Research Arm Test score increased from 1/57 to 18/57, and BCI accuracy reached 95%. To contextualize these findings, a focused literature review situates this case within emerging GRASS informed research, illustrating how standardized reporting addresses methodological heterogeneity identified in recent studies.

conclusionThis case report and literature review illustrate the feasibility of a GRASS-guided BCI rehabilitation approach and highlight the potential value of standardized reporting for improving reproducibility in post-stroke neurorehabilitation research.