Effects of mental imagery on lower limb function in sub-acute stage of stroke patients; a randomized controlled trial (original) (raw)
Related papers
2019
Objectives: To find out the role of mental imagery [visual] in sub-acute stage of stroke patient specifically considering function of lower limb. Material and Methods: An Experimental Randomized Controlled Trial was done. A total of 80 patients were taken by nonprobability consecutive sampling technique and then randomly divided into 2 groups. One group was given just conservative treatment i.e, strengthening and balancing training and the other was given conservative treatment along with visual imagery. Later independent sample t test and paired sample t test were used. The duration of the study was 2 months from July to August 2018. Results: Results regarding within group comparison in mental imagery group showed that there was mean difference of 4.88±1.71 with significant difference having p-value 0.00, while those of for conservative group, mean, standard deviation and pvalue were 3.96±1.48 and 0.090 respectively. Results regarding within group comparison of time up and go test for mental imagery group showed that there was mean difference of 4.44±1.35 with significant difference having p-value 0.000, while those of for conservative group, mean, standard deviation and p-value were 3.12±0.971 and 0.070 respectively. Conclusion: It was concluded that patients receiving conservative treatment along with visual imagery showed much better results than patients having conservative treatment alone.
Functional Recovery of Upper Limb Post-Stroke: Mental Practice with Motor and Non-Motor Imagery
American Medical Journal, 2012
The aim of this study was to investigate the efficacy of MP with motor imagery on motor recovery of the paretic upper limb of poststroke patients in comparison with MP with non-motor imagery. Approach: Four post-stroke patients were divided into two groups: experimental (the physical practice of motor tasks and MP of the same tasks: n = 2) and control (the physical practice of motor tasks and MP of non-motor tasks: n = 2). We evaluated: Heart Rate (HR) and systolic (SBP) and Diastolic Blood Pressure (DBP), immediately before and after execution and imagination of the tasks; time of execution and imagination of each task; and motor function of the paretic upper limb through the questionnaires "Fugl-Meyer for Upper Extremity" and "quality of movement section of arm motor ability test" before and after the 10 weeks of treatment. Results: The qualitative analysis showed that regardless of training, patients spent less time on imagery motor tasks than to execute them; and have increased in HR, SBP and DBP after execution as well as after imagery of motor tasks. The training caused a reduction in the time of execution of motor tasks in both groups and increment on the motor function of the paretic upper limb only in the experimental group. Conclusion: These results suggest that an MP with motor imagery may be an effective method for the functional recovery of the paretic upper limb of post-stroke patients.
Motor Imagery for Stroke Rehabilitation: Current Research as a Guide to Clinical Practice
Alternative and Complementary Therapies, 2004
he practice of mental imagery is an internal, self-regulatory process of wish fulfillment. 1 As an integral part of goaldirected behavior, mental imagery affords the ability to visualize a possible future, act according to an imagined plan, and evaluate performance. 2 Rather than a series of actual "pictures" in the brain, mental imagery is a multidimensional, heuristic experience that shares a number of features with other aspects of cognitive processes integral to motor control, such as attention, perception, planning, visuospatial reasoning, and memory. 3 The expression of an image is one way implicit cognitive information is made explicit. 4 Seeing with the "mind's eye" through spontaneous-and guided-imagery has been integral to individual and communal healing rituals for thousands of years. 5 The transformational power of imagery to heal disease through memory, dreams, and hallucinations has been reported in many testimonials even in modern Western medicine. 6 An expression of mind-body integration, imagery can be expressed through various modalities (visual, auditory, gustatory, proprioceptive, or synesthetic). 7 It is the mental practice of motor imagery [author's italics], however, that is particularly relevant to physical medicine and rehabilitation. 8 Motor imagery practice (MIP) involves imaging whole, complex tasks or succinct components of tasks while inhibiting actual movement. MIP is distinguished from other forms of imaging in that clinical protocols are designed to simulate functional tasks. Mentally practicing motor imagery has been shown to be effective in for enhancing motor learning and performance, helping healthy, (i.e., non-neurologically impaired) persons acquire new skills, modify older skills, alter maladaptive habits, and overcome psychologic or physical obstacles. 9 This article is a review of the feasibility of applying MIP to improve functional recovery in persons after stroke. This review includes the basic theories and outcome measures of MIP in recovery of upper-extremity function after stroke.
Evidence-Based Complementary and Alternative Medicine, 2012
Mental imagery can improve motor performance in stroke populations when combined with physical therapy. Valid and reliable instruments to evaluate the imagery ability of stroke survivors are needed to maximize the benefits of mental imagery therapy. The purposes of this study were to: examine and compare the test-retest intra-rate reliability of the Movement Imagery Questionnaire-Revised, Second Edition (MIQ-RS) in stroke survivors and able-bodied controls, examine internal consistency of the visual and kinesthetic items of the MIQ-RS, determine if the MIQ-RS includes both the visual and kinesthetic dimensions of mental imagery, correlate impairment and motor imagery scores, and investigate the criterion validity of the MIQ-RS in stroke survivors by comparing the results to the KVIQ-10. Test-retest analysis indicated good levels of reliability (ICC range: .83–.99) and internal consistency (Cronbachα: .95–.98) of the visual and kinesthetic subscales in both groups. The two-factor str...
Motor Imagery and Stroke Neurorehabilitation: An Overview of Basic Concepts and Therapeutic Effects
2011
Problem statement: Motor Imagery (MI), which corresponds to an active process during which the representation of a specific action is internally reproduced into working memory without any motor output. It represents the result of conscious access to the content of a movement intention, which is usually performed unconsciously during movement preparation. Approach: This review study aims to provide information on the current research and main findings related to the potential therapeutic effects of motor imagery on stroke neurorehabilitation. Results: Several studies demonstrate that conscious motor imagery and unconscious motor preparation share common mechanisms and are functionally equivalent, improving recovery of motor skills in stroke patients. Conclusion: In conclusion, motor imagery, proved very useful and effective, with significant results in improvement of motor deficits in post stroke patients. Thus, it is recommended that further studies must be conducted to determine specific parameters such as number and weekly frequency, duration (minutes per session), type (visual or kinesthetic) and the appropriate moment to apply mental practice (phases recovery of pathology), in order to create specific protocols for each treatment phase.
Journal of rehabilitation medicine, 2014
Objective: To evaluate the effect of mental practice on motor imagery ability and assess the influence of motor imagery on gait rehabilitation in sub-acute stroke. Design: Randomized controlled trial. Subjects: A total of 44 patients with gait dysfunction after first-ever stroke were randomly allocated to a motor imagery training group and a muscle relaxation group. Methods: The motor imagery group received 6 weeks of daily mental practice. The relaxation group received a muscle relaxation programme of equal duration. Motor imagery ability and lower limb function were assessed at baseline and after 6 weeks of treatment. Motor imagery ability was tested using a questionnaire and mental chronometry test. Gait outcome was evaluated using a 10-m walk test (near transfer) and the Fugl-Meyer assessment (far transfer). Results: Significant between-group differences were found, with the vividness of kinesthetic imagery and the walking test results improving more in the motor imagery group t...
Motor imagery after stroke: where next?
Imaging in Medicine, 2012
There is considerable interest in using motor imagery to improve recovery after stroke. While motor imagery has a strong neuroscientific rationale, there are significant obstacles to its use and gaps in our knowledge that need to be addressed. Together these may explain the inconsistent results seen in recent randomized placebo-controlled trials of motor imagery training in stroke patients. The first section of this article discusses why assessment of motor imagery ability is crucial when applying motor imagery to stroke patients. Then in the context of current models of recovery after stroke, the second section highlights gaps in the neuroscientific rationale behind the use of motor imagery training. The third section explores the recent randomized trials of motor imagery training in stroke patients and discusses why the findings are inconsistent. Finally, I propose future areas of research that may prove fruitful and will allow motor imagery to fulfill its potential.
To Compare Mental Practice with Motor Imagery and Mirror Therapy on Hand Function in Stroke Patients
2020
Background & Objective: To compare mental practice with motor imagery and mirror therapy on hand function in stroke patients. Method: 24 patients of stroke of different age and gender were recruited and subjects who met the inclusion criteria were randomly allocated into 2 groups: Group Apatients undergone Motor Imagery& Group Bpatients undergone Mirror Therapy. Preand post assessment of hand function assessed using fuglmeyer scale and Action Research Arm Test (ARAT).Patients diagnosed with CVA, age between 41-65 years, medically stable after acute CVA, both male and female were included. Patients with upper limb amputation, upper limb fracture, with artificial joints, having severe cognitive impairments, brain injury and surgery, diagnosed with any other neurological disorders were excluded. Result: In Group-A (Motor Imagery) and Group-B (Mirror Therapy), all data was expressed as mean ±, SD and was statistically analyzed using paired ‘t’ test and independent ‘t’ test to determine ...
Recovery of Motor Imagery Ability in Stroke Patients
Rehabilitation Research and Practice, 2011
Objective. To investigate whether motor imagery ability recovers in stroke patients and to see what the relationship is between different types of imagery and motor functioning after stroke. Methods. 12 unilateral stroke patients were measured at 3 and 6 weeks poststroke on 3 mental imagery tasks. Arm-hand function was evaluated using the Utrecht Arm-Hand task and the Brunnström Fugl-Meyer Scale. Age-matched healthy individuals (N = 10) were included as controls. Results. Implicit motor imagery ability and visual motor imagery ability improved significantly at 6 weeks compared to 3 weeks poststroke. Conclusion. Our study shows that motor imagery can recover in the first weeks after stroke. This indicates that a group of patients who might not be initially selected for mental practice can, still later in the rehabilitation process, participate in mental practice programs. Moreover, our study shows that mental imagery modalities can be differently affected in individual patients and over time.
Clinical Assessment of Motor Imagery After Stroke
Neurorehabilitation and Neural Repair, 2007
Objective. The aim of this study was to investigate: (1) the effects of a stroke on motor imagery vividness as measured by the Kinesthetic and Visual Imagery Questionnaire (KVIQ-20); (2) the influence of the lesion side; and (3) the symmetry of motor imagery. Methods. Thirty-two persons who had sustained a stroke, in the right (n = 19) or left (n = 13) cerebral hemisphere, and 32 age-matched healthy persons participated. The KVIQ-20 assesses on a 5-point ordinal scale the clarity of the image (visual scale) and the intensity of the sensations (kinesthetic scale) that the subjects are able to imagine from the first-person perspective. Results. In both groups, the visual scores were higher (P = .0001) than the kinesthetic scores and there was no group difference. Likewise, visual scores remained higher than kinesthetic scores irrespective of the lesion side. The visual scores poststroke were higher (P = .001) when imagining upper limb movements on the unaffected side than those on the affected side. When focusing on the lower limb only, however, the kinesthetic scores were higher (P = .001) when imagining movements of the unaffected compared to those on the affected side. Conclusions. The vividness of motor imagery poststroke remains similar to that of age-matched healthy persons and is not affected by the side of the lesion. However, after stroke motor imagery is not symmetrical and motor imagery vividness is better when imagining movements on the unaffected than on the affected side, indicating an overestimation possibly related to a hemispheric imbalance or a recalibration of motor imagery perception.