PMC8313089_01
Timeline with relevant data from the episode of care, *details in Supplementary Material.
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F1
Supplementary Material). She underwent physiotherapy immediately following her discharge and had acupressure-therapy, acupuncture-therapy, home-based exercises for an initial few (~5) years before enrolling in this study, (Timeline Figure 1, full details in Supplementary Material). The device (Supplementary Figure 1) is actively initiated by EMG activity of Extensor Digitorum Communis (EDC) muscle with robot motion triggered only if the EMG thresholds are crossed and it provides an interactive adaptive performance visual biofeedback in real-time.
BOLD images for wrist extension task with voxel level threshold p < 0.05 (FWE-corrected) and cluster size threshold of 10 voxels. Thirty-one ascending transversal slices, repetition time (TR): 2,000 ms, field of view (FOV): 230 x 230 x 155 mm, Flip-angle: 90 degrees, voxel size: 1.8 x 1.8 x 5 mm and echo time (TE) = 30 ms. Presentation on MR compatible 20" LCD monitor (Esys in vivo eprime 1.1) with projection on mirror attached to head coil where image-of-hand notifies the active-block and cross on image-of-hand represents the rest-block. Data-analysis (in SPM12) included realignment by aligning images to mean-image, co-registration using T1-image, normalized, and smoothing with 8 x 8 x 8 Full Width at Half-Maximum (FWHM) filter on pre and post-BOLD images. Talairach-client was used to correlate MNI-coordinates with gray and white matter. (a,c) are pre-robotic training images, (b,d) are post-robotic training images during affected-hand trial, (e,g) are pre-robotic training images and, (f,h) are post-robotic training images of masked regions cerebellum (-52:8: -20 slices) and sensorimotorcortex (48:6:72 slices) during the unaffected-hand trial (p < 0.05).
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F2
Structural T1 image (Supplementary Figure 2) and fMRI BOLD images were acquired for affected and unaffected hand movement, using 3T MR-scanner (Achieva 3T TX, M/s. Post-therapy, during the affected-hand trial, the number of activated voxels were observed to substantially decrease in ipsilesional sensorimotor-cortex (SMC) - precentral (from 1346 to 114) and postcentral-gyrus (from 914 to 100) (Figure 2, Table 2). Post-therapy, during the unaffected hand trial, the number of activated voxels were decreased in contralateral/contralesional SMC - precentral (from 930 to 168) and postcentral-gyrus (from 655 to 58) (Figure 2, Table 2).