AUTHOR=Singh Neha , Saini Megha , Kumar Nand , Srivastava M. V. Padma , Kumaran S. Senthil , Mehndiratta Amit 

TITLE=A Case Report: Effect of Robotic Exoskeleton Based Therapy on Neurological and Functional Recovery of a Patient With Chronic Stroke

JOURNAL=Frontiers in Neurology

VOLUME=Volume 12 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.680733

DOI=10.3389/fneur.2021.680733

ISSN=1664-2295

ABSTRACT=BACKGROUND: A novel electromechanical robotic-exoskeleton was developed in-house for
 distal-joints for post stroke rehabilitation. The objective was to explore the functional MRI and the neurophysiological changes in cortical excitability in response to exoskeleton training for 9
year chronic-stroke.  CASE-REPORT: The study involved a 52-year old female patient with a 9-year chronic-stroke of the right-hemisphere, who underwent 20 therapy-sessions of 45 minutes each. Cortical- excitability and clinical-scales: Fugl-Mayer (FM), Modified Ashworth Scale (MAS),
 Brunnstrom-Stage (BS), Barthel-Index (BI), Range of Motion (ROM), were assessed pre-and
 post-therapy to quantitatively assess the motor recovery. CLINICAL OUTCOMES: Increase in FM wrist/hand by 6, BI by 0 and decrease in MAS by were reported. Ipsilesion Motor Evoked Potential (MEP) (obtained using Transcranial Magnetic Stimulation) was increased by 98μV with a decrease in RMT by 6% and contralesional MEP was increased by 43μV with a decrease in RMT by 4%. Laterality Index of Sensorimotor Cortex (SMC) reduced in precentral- gyrus (from 0.152 to -0.707) and in postcentral-gyrus (from 0.203 to -0.632) with an overall change of ~0.85 in SMC
 demonstrating substantial shift in activation towards ipsilesional-hemisphere. Exoskeleton-
 based training might push the limits of recovery in chronic stroke.