Begin by explaining the training purpose and method to the patient. Put the MIBCI EEG cap on the patient ensuring that the Cz point of the cap coincides with that of the patient's head. Confirm the position of the EEG cap by checking the intersection point of the ear bead line and the human median line passing through the nose and eyebrow center.
Keep the ears exposed from the ear seam of the head cap and adjust the chinstrap to fix the head cap. Insert 24 electrodes dipped in normal saline into the groove of the EEG cap and clip two reference electrodes into the two ear lobes. Put the manipulator on the patient and adjust it to a comfortable training position to prevent upper limb forearm pain.
Then open the training software MIBCI upper limb hand function rehabilitation robot. Click the user list and enter the patient information, including name, disease name, date of birth, date of illness, and location of the affected side. Adjust the stability of the EEG signal to no obvious clutter and click the resting EEG button.
Let the patient complete the resting EEG acquisition process according to the voice and text prompts. Click the task setting button and according to the situation of the patient, set the initial training difficulty upward or downward from level nine. Also set the training duration to 30 minutes.
Click the task EEG button to start the formal training. Ask the patient to follow the onscreen text that asks them to close their eyes and relax for five seconds. After five seconds, ask the patient to open their eyes and follow the onscreen commands.
The screen on the patient's side displays the gripping or opening video to assist the patient to imagine the actions. Ask the patient to perform the motion imagination task for five seconds. After another four seconds, check the motor intention.
If the intention is less than 60 points, the system determines that the patient cannot perform the movement. During the training, the MIBCI system will automatically adjust the task difficulty according to the patient's performance. For course movements, the task difficulty is simple, making it easier for the patient to complete.
Conversely, for fine movements, the task becomes more difficult, making it challenging for the patient to complete. If the patient has pain or discomfort during the training, stop the training and record the reason for termination. During the training, observe the EEG waveform in real time.
If there is a small range of EEG disturbances, check the corresponding electrode for dryness. Stop the training and EEG acquisition immediately and properly wet the electrode before continuing. If the EEG signal has an extensive range of disturbance, check whether the reference electrode has fallen off.
Stop the training immediately and clamp the reference electrode at the ear lobe again. After the test, evaluate the motor function by Fugl-Meyer Assessment of Upper Extremity out of a total score of 66. Also, evaluate the Wolf Motor Function Test out of a total score of 85.
Perform cognitive function assessment by mini mental state examination on stroke subjects and divide the score according to the educational level. Also, evaluate the emotional function on patients using Hamilton Anxiety Scale and calculate the scores during the assessment process. Then, evaluate the emotion function using the Hamilton Depression Scale.
MIBCI intervention was performed on a 36-year-old male stroke patient diagnosed with left limb motor dysfunction. Brain function and clinical function assessment before and 10 days after treatment showed improvement in FMAUE and WMFT scores.
