Study: NCT05520489

Intervention type: DEVICE
Group type: ACTIVE_COMPARATOR
Intervention: Repetitive Transcranial Magnetic stimulation
Description: Participants received 15 sessions (15 daily session - Monday to Friday) of active rTMS over the 'hotspot M1 area of the unaffected hemisphere leading to a response in the contralateral thenar muscle using Visor2-navigation system and MagstimRapid -magnetic stimulator. . Hot spot localization was performed by stimulation with 50%:n intensity and found the maximum response area, where the coil was placed using the navigator cursor. The motor threshold was found using Maximum-Likelihood Strategy -algorithm of MTAT system.~Low frequency rTMS was applied at 80-90% resting motor threshold (rMT) intensity, 1 Hz, 600+600 pulses, inbetween 10 minutes break. Intensity was increased after each 2-3 treatment to keep motor threshold 90%.

Intervention type: DEVICE
Group type: ACTIVE_COMPARATOR
Intervention: Repetitive Transcranial Magnetic stimulation
Description: Participants received 15 sessions (15 daily session - Monday to Friday) of active rTMS over the 'hotspot M1 area of the unaffected hemisphere leading to a response in the contralateral thenar muscle using Visor2-navigation system and MagstimRapid -magnetic stimulator. . Hot spot localization was performed by stimulation with 50%:n intensity and found the maximum response area, where the coil was placed using the navigator cursor. The motor threshold was found using Maximum-Likelihood Strategy -algorithm of MTAT system.~Low frequency rTMS was applied at 80-90% resting motor threshold (rMT) intensity, 1 Hz, 600+600 pulses, inbetween 10 minutes break. Intensity was increased after each 2-3 treatment to keep motor threshold 90%.

Intervention type: DEVICE
Group type: ACTIVE_COMPARATOR
Intervention: Robot Assisted Therapy
Description: This was delivered using the Diego and Pablo (Tyromotion GmBH) robotic gym system. Participants receive robot-assisted training for up to 60 min per day, four days per week for 3 weeks, in addition to usual care. Robotic devices enable 3D interactive exercising, using weight reducing system in Diego and fine motor training in Pablo. Exercises can be one- or two-handed and/or symmetrical. Patient performs 150-400 repetitions in one therapy session. Estimated time is 2-3 minutes per one exercise section. Standard minimum program includes 4 games: swimming, shooting, ship and apple orchard. The therapist instructs the patient and assure the position of trunk and shoulder girdle.

Intervention type: DEVICE
Group type: ACTIVE_COMPARATOR
Intervention: Robot Assisted Therapy
Description: This was delivered using the Diego and Pablo (Tyromotion GmBH) robotic gym system. Participants receive robot-assisted training for up to 60 min per day, four days per week for 3 weeks, in addition to usual care. Robotic devices enable 3D interactive exercising, using weight reducing system in Diego and fine motor training in Pablo. Exercises can be one- or two-handed and/or symmetrical. Patient performs 150-400 repetitions in one therapy session. Estimated time is 2-3 minutes per one exercise section. Standard minimum program includes 4 games: swimming, shooting, ship and apple orchard. The therapist instructs the patient and assure the position of trunk and shoulder girdle.

Intervention type: OTHER
Group type: ACTIVE_COMPARATOR
Intervention: Enhanced upper limb therapy programme
Description: Exercises were performed by using different objects for task orientated movements. The therapist provided assistance as needed and encouraged participants to complete the tasks. Training was divided to 3 sessions for fine motor training and complex training and 1 session for shoulder girdle and complex training per week for 3 weeks, in addition to usual care. Each session lasts 1 hour and estimated time is 2-5 min to each exercise section.

Intervention type: OTHER
Group type: ACTIVE_COMPARATOR
Intervention: Enhanced upper limb therapy programme
Description: Exercises were performed by using different objects for task orientated movements. The therapist provided assistance as needed and encouraged participants to complete the tasks. Training was divided to 3 sessions for fine motor training and complex training and 1 session for shoulder girdle and complex training per week for 3 weeks, in addition to usual care. Each session lasts 1 hour and estimated time is 2-5 min to each exercise section.