Article Figures & Data
Figures
- Figure 1.
Schematic representation of the planar reaching task. a, Smooth table surface. b, Arm support air sled. c, LED cursor, positioned on top of the air sled. d, Targets, projected to plane of the arm from e, LED lights panel via f, two-way mirror.
- Figure 2.
Group results for the single-day study in healthy triceps. A, Results for the StartReact assessment (contralateral audio N = 7, ipsilateral audio N = 8, both groups combined N = 15). The figure represents StartReact effect (difference between VART and VSRT). a, StartReact effect before (cyan) and after (red) wearable device stimulation. Colored bars represent group means; error bars indicate SDs. b, difference in StartReact effect between before and after wearable device stimulation. A positive difference indicates a more pronounced StartReact effect after wearable device stimulation. Bars represent group means; circles show single subject values. c, Number of subjects showing an increase (yellow) or decrease (blue) in StartReact effect after wearable device stimulation. B, Results for the conditioned MEPs with loud sounds. The figure represents conditioned MEP amplitude normalized to unconditioned amplitude (as percentage of control). Layout is the same as for A. C, Results for the coil orientation assessment when stimulation with an AP coil orientation. The figure represents MEP amplitude as area under the curve. For one subject stimulation threshold was too high to detect AP MEPs, so subject was excluded for the coil orientation assessment (contralateral audio N = 6, ipsilateral audio N = 8, combined N = 14). Layout is the same as for A. D, Results for the coil orientation assessment when stimulation with a PA coil orientation. The figure represents MEP amplitude as area under the curve. For one subject stimulation threshold was too high to detect AP MEPs, so subject was excluded for the coil orientation assessment (contralateral audio N = 6, ipsilateral audio N = 8, combined N = 14). Layout is the same as for A.
- Figure 3.
Consort diagram. Trial flow diagram for the SCI study. Participants were randomized into two groups (A, B), which both spent four weeks wearing the device and four weeks without wearing the device, but in opposite order. Subsequent analysis is based on the remaining 15 participants.
- Figure 4.
Compliance of device usage in SCI participants. The device recorded the number of stimuli given over the four-week period. Gray dashed line represents total number of stimuli received if the device was used as instructed, with a minimum usage of 4 h/d over the period of four weeks (28 d). Circles represent individual participants (N = 16). One subject receiving a very low number of stimuli was subsequently excluded from analysis.
- Figure 5.
Group results for the SCI study. A, Results for the CUE questionnaire (N = 15). The figure represents the total score achieved in the CUE questionnaire. a, Total CUE score before (cyan) and after (red) four weeks of wearing the device (device) or four weeks of not using the device (none). Colored bars represent group means; error bars indicate SDs. b, Difference in total CUE score between before and after using the device or not. A positive difference indicates an increase in total score after four weeks. Bars represent group means; circles show single subject values. c, Number of subjects showing an increase (yellow) or decrease (blue) in total score after four weeks. B, Results for the maximal force produced during elbow flexion (N = 15). The figure represents mean maximal force, measured with a force plate. Layout is the same as for A. C, Results for the maximal force produced during elbow extension (N = 15). The figure represents mean maximal force, measured with a force plate. Layout is the same as for A. D, Results for the active motor threshold of MEPs elicited with PA coil orientation (N = 15). The figure represents AMT. Layout is the same as for A. E, Results for the active motor threshold of MEPs elicited with AP coil orientation. For two subjects AMT was too high to detect AP MEPs (N = 13). The figure represents AMT. Layout is the same as for A.
- Figure 6.
Group results for StartReact, startle TMS and MEPs with different coil orientations. A, Results for the StartReact assessment. For one subject equipment failure prevented recordings, so subject had to be excluded for this assessment (N = 14). The figure represents StartReact effect (difference between VART and VSRT). a, StartReact effect before (cyan) and after (red) wearing the device for four weeks (device) or four weeks of not using the device (none). Colored bars represent group means; error bars indicate SDs. b, Difference in StartReact effect between before and after using the device or not. A positive difference indicates a more pronounced StartReact effect after four weeks. Bars represent group means; circles show single subject values. c, Number of subjects showing an increase (yellow) or decrease (blue) in StartReact effect after four weeks. Asterisks indicate proportions significantly different from the 50% expected by chance. B, Results for the conditioned MEPs with loud sounds (N = 15). The figure represents conditioned MEP amplitude normalized to unconditioned amplitude (as percentage of control). Layout is the same as for A. C, Results for the coil orientation assessment. For two subjects stimulation threshold was too high to detect AP MEPs, so subjects were excluded for the coil orientation assessment (N = 13). The figure represents MEP amplitudes elicited by AP orientation normalized to MEP amplitudes elicited by PA orientation. Layout is the same as for A.
- Figure 7.
Group results for the planar reaching task. Two subjects were unable to perform the required reaching movements and group analysis is based on the remaining 13 participants. A, Maximal speed of trajectories achieved while reaching for each target (Targets 1–8, boxed numbers). a, Mean maximal speed (in m/s) of trajectories across SCI participants at baseline (N = 13). Purple line represents mean values, shaded area represents standard deviation. b, Difference in maximal speed (in m/s) between before and after four weeks of using the device (light blue) or not (orange). c, Number of subjects showing an increase (yellow) or decrease (blue) in maximal speed after four weeks of using the device. d, Number of subjects showing an increase (yellow) or decrease (blue) in maximal speed after four weeks of not using the device. B, Maximal distance from straight line (in mm) while reaching for each target (Targets 1–8). Layout is the same as for A. C, Mahalanobis distance squared (MDC2) of trajectories for each target (Targets 1–8). MDC2 was calculated by comparing trajectories from SCI participants (N = 13) with trajectories from healthy controls (N = 18) with functional PCA. a, Mean MDC2 across SCI participants (purple) and healthy controls (amber). Layout is the same as for A. Stars indicate proportions significantly different from the 50% expected by chance, for that target.
Tables
Assessments Single-day study in
healthy volunteersSCI
studyStartReact x x Loud sound with MEP x x MEPs with different coil Orientation x x Force x Planar reaching task x CUE Questionnaire x Participant no. Age (years) Gender Level Injury (years) Arm Device usage (d) 1 35 F C5 incomplete 2 R 28 2 32 F C5–C6 incomplete 3 R 27 3 52 M C3–C4 incomplete 6 R 28 4 67 M C3–C4 incomplete 13 R 28 5 39 M C5–C6 incomplete 17 R 28 6 62 M C5–C6 complete 28 R 28 7 45 F C4 incomplete 17 R 28 8 30 M C4 complete 11 R 31 9 34 M C4 complete 5 R 29 10 67 F C3–C7 incomplete 4 R 28 11 60 F C2–T2 incomplete 15 L 35 12 22 M C5 incomplete 5 L 28 13 47 F C4–C5 incomplete 3 L 28 14 39 M C4–C5 incomplete 2 R 28 15 47 M C6 complete 22 L 28 16 34 M C4–C5 incomplete 10 R 40 Participant number 16 was subsequently excluded from analysis because of low compliance.
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