PMC9911819_01
Results of the short-term evaluations. Synchronized stimulation improved the gait speed measured by the 10-m gait test, TUG test, and muscle strength of the lower limbs (interventions A1 and A2), whereas sham or asynchronized stimulation did not improve the gait speed (interventions B and C). 10 m gait CS: 10-m walk test at a comfortable speed, 10 m gait MS: 10-m walk test at a maximal speed, TUG: Timed Up and Go test.
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F1
TUG and muscle strength of the lower limbs after interventions A1 and A2 compared with those after interventions B and C (Figure 1). The kinematic parameters showed the largest improvements in planarity on the non-paretic side after the A1 and A2 interventions (Figures 2A, B).
Kinematic gait parameters before and after the short-term interventions. Planarity of the paretic and non-paretic sides of the lower limbs (A) and areas of the gait loop (GLA) asymmetry (B) are shown before and after each of the interventions (the pre- and post-conditions of the A1, B, A2, and C interventions).
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F2
TUG and muscle strength of the lower limbs after interventions A1 and A2 compared with those after interventions B and C (Figure 1). The kinematic parameters showed the largest improvements in planarity on the non-paretic side after the A1 and A2 interventions (Figures 2A, B).
Results of the long-term evaluations. The clinical parameters are shown before, immediately after, and 2 weeks after the intervention (A) The results of the 10 m CS and MS gait tests show an increased velocity, decrease of the number of steps, and decrease of the time of the TUG test (B) Muscle strength of the ankle joint is increased after the intervention (C) MAS scores are lower after the intervention (D) FMA and mini-BESTest scores are improved after the intervention. CS, comfortable speed; MS, maximal speed; TUG, Timed Up and Go; MAS, modified Ashworth scale; FMA-LE, Fugl-Meyer Assessment Lower Extremity; mini-BESTest, mini-Balance Evaluation Systems Test.
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F3
The additional long-term follow-ups of the synchronized brain stimulation with robot-assisted training increased gait velocity, decreased the number of steps in the 10-m gait test at the comfortable speed and maximal speed, and shortened the time measured by the TUG test, suggesting that gait and balance function were improved (Figure 3A). Muscle strength also increased in plantar flexion and dorsiflexion of the affected ankle (Figure 3B). The spasticity measured by the MAS was decreased in the hamstring and triceps surae of the affected side (Figure 3C). The FMA and mini-BESTest scores increased, suggesting improvements in general motor and balance functions (Figure 3D).