Motor Imagery Training for Upper Limb Functional Strength in Chronic Stroke Patients

Overview

Stroke is a leading cause of upper extremity deficits worldwide. Persistent upper extremity dysfunction affects many post stroke patients and is strongly associated with decreased activities of daily living and poor quality of life. There is accumulating evidence of a cross-over effect with training of one limb that slightly increase strength and coordination in contralateral untrained limb through neurological adaptations. One of rehabilitation that is beneficial for stroke patient is motor imagery, a mental rehearsal of a movement that does not include physical movement has been shown to enhance upper limb function. Evidence demonstrate that MI not only activates motor cortical and subcortical regions but also induces plastic change in motor networks and modulates synaptic activity at spinal level.

Detailed description

OBJECTIVE:

The objectives of this study are:

1. To improve upper limb functional strength. 2. To improve the upper limb coordination. 3. To improve upper limb functional improvement.

HYPOTHESIS

Alternate Hypothesis:

There will be statistically significant difference in effects of motor imagery technique combined with conventional physical therapy and in comparison to conventional physical therapy alone on upper limb functional strength, coordination and functional improvement in chronic stroke. (p\<0.05).

Null Hypothesis:

There will be no statistically significant difference in effects of motor imagery technique combined with conventional physical therapy and in comparison to conventional physical therapy alone on upper limb functional strength, coordination and functional improvement in chronic stroke. (p\>0.05).

Research Design: Experimental study. Randomized Control Trial

Interventions

• Procedure Intervention Group A Conventional Physical Therapy
  Active Range of Motion Exercises: (5-10 reps with 2 sets) Finger bends, finger spreads, finger to thumb opposition, thumb to palm stretches, palm up and down, wrist rotation, wrist bends, elbow bends, shoulder shrugging and shoulder rotation. Strengthening Exercises: (10-15 reps 2 sets weight 500 ml to 1L water bottle). Finger pinch, power grip, finger spread, pushing movement, wrist curls, roll and squeeze, bicep curls, side arm raise, lifting objects to a height, pulling resistance band. Coo
• Procedure Intervention Group B Motor Imagery with Conventional Physical Therapy
  1. Subjects will be asked to sit comfortably on a chair with a backrest. A Quiet environment is ensured for proper concentration of subject .Take deep breaths for 2-3 min to relax. 2. Subjects will be asked to close their eyes and imagine the training scene for each task for 5 min while listening to the therapist 's voice describing the motion. 3. The non-paralysis part of the body's movement was imagined first and then the movement of the paralysis part was imagined. 4. Upon completion of the m

Primary outcome measures

• FUNCTIONAL STRENGTH [Time frame: 8 weeks]
• Coordination [Time frame: 8 weeks]

Eligibility criteria

Inclusion criteria

• Stroke duration 6 months onwards (chronic stroke).
• age 45 years and above.
• Both genders.
• Access cognitive function score > 24 on MoCA.

Exclusion criteria

• Patients with any comorbidity, previous surgery and congenital anomly.
• Patient with any fracture/ MSK disorders.
• Score 3 or more on Modified Ashworth scale.
• Patients with hearing impairments

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

N/A

Model

Parallel assignment

Masking

Open label

Primary purpose

Treatment

Study locations

Pakistan · 1 center

• Foundation University College of Physical Thrapy — Islamabad

Identifiers

NCT: NCT06945185 · FUI/CTR/2024/64

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗