To investigate the short-term effects of brain-computer interface (BCI) rehabilitation training combined with traditional rehabilitation therapy on short-term motor function improvement in the acute phase of cerebral infarction, and to explore the clinical value of ultra-early intervention initiated within 48 hours after stroke onset.

Patients with acute cerebral infarction admitted to the Department of Neurology, the First Hospital of Hebei Medical University from July to December 2025 were prospectively enrolled. Both groups received routine neurological treatment, and were divided into a treatment group (BCI rehabilitation training combined with traditional rehabilitation therapy) and a control group (traditional rehabilitation therapy) according to rehabilitation methods. The median rehabilitation cycle of the two groups was 5 days. The motor function of the two groups was assessed by the Fugl-Meyer assessment scale (FMA), and the degree of functional improvement was evaluated by the difference in FMA scores (ΔFMA) between before and after rehabilitation training. Mann-Whitney U test was used to compare the differences between groups. Based on the start time of BCI rehabilitation training, the patients of treatment group were divided into a group initiating training within 48 hours of onset and a group initiating training ＞48 hours after onset, and the subgroup analysis of ΔFMA was performed.

The treatment group included 40 patients, and the control group included 21 patients. Before rehabilitation, the FMA upper limb scores of treatment group and control group were 22.00 (14.00, 28.75) and 27.00 (21.50, 31.00), the FMA lower limb scores were 19.00 (16.00, 22.00) and 22.00 (18.50, 25.50), and the total FMA scores were 46.50 (33.25, 61.75) and 64.00 (47.00, 75.50), and the differences were statistically significant (U=288.500, 257.000, 269.000; P=0.046, 0.013, 0.022). At the end of rehabilitation, the total FMA scores of treatment group and control group were 55.00 (40.25, 68.00) and 67.00 (52.50, 77.00), respectively, and the difference was statistically significant (U=303.500, P=0.007). The ΔFMA upper limb scores of treatment group and control group were 1.00 (0, 3.50) and 0 (0, 1.00), the ΔFMA lower limb scores were 3.00 (2.00, 4.00) and 2.00 (1.00, 2.00), and the ΔFMA total scores were 5.00 (3.00, 9.75) and 3.00 (2.00, 4.50), and the differences were statistically significant (U=283.500, 226.000, 249.000; P=0.030, 0.003, 0.009). The results of subgroup analysis showed that the ΔFMA upper limb, wrist joint, hand, lower limb scores and total scores of patients in the rehabilitation training group within 48 hours of onset tended to be higher than those in the rehabilitation training group ＞48 hours of onset, but the differences were not statistically significant (all P＞0.05).

BCI rehabilitation training combined with traditional rehabilitation therapy can quickly improve the short-term motor function of patients with acute cerebral infarction, and ultra-early ( within 48 hours of onset ) starting BCI rehabilitation training may be more beneficial for motor function recovery.