Trigno wireless sensors

Surface EMG was recorded from six muscles of the upper body on the more-affected side: trapezius (middle portion), deltoid medius, biceps brachii (BB), extensor carpi radialis, flexor carpi radialis, and first dorsal interosseus (FDI) using Trigno wireless sensors (Delsys, USA). The data were collected continuously during formal WMT sessions at early (day 2–3) and late (between days 12–14) therapy, and in a subset of patients, again during the 6-month follow-up session. Each EMG sensor contains four silver bar electrodes, arranged in two pairs with an interelectrode pair distance of 10 mm. The sensor is designed to maximize the detection of muscle activation in a field perpendicular to the muscle fibers. Data were amplified 300 times, filtered between 20 and 450 Hz, and sampled at 2 kHz using EMGworks (Delsys, USA) as per intrinsic device settings.

We used single- and paired-pulse TMS (Magstim 200² device with BiStim module; Magstim Inc., United Kingdom) with a figure-of-eight coil combined with the Brainsight neuronavigation system (Rogue Resolutions Ltd., United Kingdom) and surface electrodes to record muscle activity (EMG; Delsys Trigno wireless sensors, Delsys Inc., MA, United States). To localize the motor hotspot, we recorded EMG at the right first dorsal interosseous (FDI). We then recorded the patient’s resting motor threshold (RMT) and recruitment curve in each hemisphere by acquiring 5 MEPs at each of the following threshold 100, 110, 120, 130, 140, and 150% of the RMT.

Two WBV machines were used to provide the mechanical vibration frequencies of 3 Hz (i-Vib5050, Real Masters of Health, Taiwan) and 20 Hz (Zen PRO TVR 3900, Jhen-Zan Enterprise, Taiwan) in our study. The Trigno wireless sensors (Delsys, USA) were used to record the EMG signals of selected muscles (sampling rate at 1000 Hz) and the accelerations of the shank and thigh segments (sampling rate at 100 Hz).