Effects of Mental Practice for Mobility in Post-stroke Hemiparesis

NCT02540096 | Unknown

• 1 other identifier: 43659515.4.0000.5103
• Study Type: interventional
• Target: 16
• Locations: 1 country
• Sites: 1

Brief Summary

Stroke is a neurovascular event characterized by impaired blood supply to the brain due to rupture or obstruction of certain cerebral arteries, which often results in hemiparesis and can affect individuals of any age and sex, being prevalent in the elderly population. Among the main treatments available for stroke rehabilitation, most of them demands an appropriate structure and high-qualified personnel. Searching for more affordable treatment options, several studies suggest the use of mental practice with motor imagery as a potential therapeutic tool, since it can be performed at any place or any time the patient wishes, including their own homes. Motor imagery can be defined as the covert cognitive process of imagining a movement of your own body(-part) without actually moving that body(-part). Within this context, the objective of this study is to investigate the effects of mental practice for mobility, gait function and speed and muscle strength of the lower limb in subacute post-stroke hemiparesis.

Conditions

Stroke; Hemiparesis

Keywords

mental practice; motor imagery; hemiparesis; stroke; gait; mobility

Outcome Measures

Primary Outcomes (2)

• Change in Timed Up and Go (TUG)

  This is a measure that examines the participant's basic mobility skills by measuring seconds to rise from sitting, walk 3 meters, return, and sitting down

  1 week before intervention; 4 weeks after intervention; 6 weeks after intervention

• 5-Meter Walk Test

  This is a measure that examines the participant's gait speed (cut off 6 seconds)

  1 week before intervention; 4 weeks after intervention; 6 weeks after intervention

Secondary Outcomes (4)

• Change in Muscle strength

  1 week before intervention; 4 weeks after intervention; 6 weeks after intervention

• Change in Quality of life

  1 week before intervention; 4 weeks after intervention; 6 weeks after intervention

• Change in Mental health

  1 week before intervention; 4 weeks after intervention; 6 weeks after intervention

• Change in TUG-ABS

  1 week before intervention; 4 weeks after intervention; 6 weeks after intervention

Study Arms (2)

Intervention (Mental Practice)

EXPERIMENTAL

Participants will be submitted to individual and structured physiotherapy sessions (the same as the control groups). They will also participate in a structured mental practice session (lasting 30 minutes and three times a week), totaling 12 sessions at the end of this intervention.

Other: Mental practice

Control group

PLACEBO COMPARATOR

Participants will be submitted to individual and structured physiotherapy sessions lasting 40 minutes. They will also participate in a cognitive training and relaxation session (lasting 30 minutes, three times a week), totaling 12 sessions.

Other: Cognitive training and Relaxation

Interventions

Mental practice OTHER

The sessions will be individualized and carried out in a peaceful setting.The aim of the mental practice protocol was to promote motor imagery of the following activities: get up from a chair and walk and sit, which enrolls the basic and instrumental activities of daily living. The sessions will consist of six steps: (1) "Physical Practice" (2) "Familiarization" (3) "Memory" (4) "Relaxation" (5) "Repeat" and (6) "post-practice mental relaxation". After the mental practice session, participants will be submitted to individual and structured physiotherapy sessions (the same as the control groups).

Intervention (Mental Practice)

Cognitive training and Relaxation OTHER

Cognitive training and relaxation session (lasting 30 minutes, three times a week), totaling 12 sessions. The sessions will consist of calculations, memorization, imagination and body relaxation exercises. These sessions will not have any motor imagery. After the cognitive training and relaxation session, participants will be submitted to individual and structured physiotherapy sessions lasting 40 minutes with muscle strengthening and stretching exercises.

Control group

Eligibility Criteria

• Age: 18 Years - 73 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• hemiparesis after ischemic stroke (15 to 180 days after the event);
• only one cerebral hemisphere affected;
• no chemical, alcohol or drug dependency;
• Score average ≥ 2,5 point in the instrument "Visual and Kinesthetic Imagery Questionnaire" (KIVQ-10);
• No cognitive impairment (18 points in the Mini-Mental State Examination - 0-4 years of educations and 24 points (\>4 years of education);
• Not participating in any other type of physiotherapy or physical activity during the study period;
• Complaining of difficulty in gait and mobility after stroke;
• Able to stand up from a chair and walk some distance with or without auxiliary device;

You may not qualify if:

• Hemorrhagic or ischemic progressing to hemorrhagic stroke;
• Score ≥ 4 on the Visual Analogue Pain Scale;
• Score ≥ 2 on the modificator Ashworth scale;
• Visual disabilities;
• Severe Aphasia;
• Cardiovascular instability and/or other neurological disorders that may impair the mobility and gait.

Sponsors & Collaborators

• Federal University of Juiz de Fora: lead

Study Sites (1)

Zaqueline Fernandes Guerra

Juiz de Fora, 36038295, Brazil

Location

Related Publications (19)

• Paolucci S, Antonucci G, Grasso MG, Morelli D, Troisi E, Coiro P, Bragoni M. Early versus delayed inpatient stroke rehabilitation: a matched comparison conducted in Italy. Arch Phys Med Rehabil. 2000 Jun;81(6):695-700. doi: 10.1016/s0003-9993(00)90095-9.

  PMID: 10857508 BACKGROUND

• Hadidi N, Buckwalter K, Lindquist R, Rangen C. Lessons learned in recruitment and retention of stroke survivors. J Neurosci Nurs. 2012 Apr;44(2):105-10. doi: 10.1097/JNN.0b013e3182478c96.

  PMID: 22367274 BACKGROUND

• Zhang S, He WB, Chen NH. Causes of death among persons who survive an acute ischemic stroke. Curr Neurol Neurosci Rep. 2014 Aug;14(8):467. doi: 10.1007/s11910-014-0467-3.

  PMID: 24951970 BACKGROUND

• Page SJ, Dunning K, Hermann V, Leonard A, Levine P. Longer versus shorter mental practice sessions for affected upper extremity movement after stroke: a randomized controlled trial. Clin Rehabil. 2011 Jul;25(7):627-37. doi: 10.1177/0269215510395793. Epub 2011 Mar 22.

  PMID: 21427151 BACKGROUND

• Page SJ. Mental practice: a promising restorative technique in stroke rehabilitation. Top Stroke Rehabil. 2001 Autumn;8(3):54-63. doi: 10.1310/7WDU-2P4U-V2EA-76F8.

  PMID: 14523738 BACKGROUND

• Page SJ, Levine P, Leonard AC. Effects of mental practice on affected limb use and function in chronic stroke. Arch Phys Med Rehabil. 2005 Mar;86(3):399-402. doi: 10.1016/j.apmr.2004.10.002.

  PMID: 15759218 BACKGROUND

• Lotze M, Cohen LG. Volition and imagery in neurorehabilitation. Cogn Behav Neurol. 2006 Sep;19(3):135-40. doi: 10.1097/01.wnn.0000209875.56060.06.

  PMID: 16957491 BACKGROUND

• Sirigu A, Duhamel JR. Motor and visual imagery as two complementary but neurally dissociable mental processes. J Cogn Neurosci. 2001 Oct 1;13(7):910-9. doi: 10.1162/089892901753165827.

  PMID: 11595094 BACKGROUND

• Jeannerod M. Neural simulation of action: a unifying mechanism for motor cognition. Neuroimage. 2001 Jul;14(1 Pt 2):S103-9. doi: 10.1006/nimg.2001.0832.

  PMID: 11373140 BACKGROUND

• Malouin F, Richards CL, Jackson PL, Lafleur MF, Durand A, Doyon J. The Kinesthetic and Visual Imagery Questionnaire (KVIQ) for assessing motor imagery in persons with physical disabilities: a reliability and construct validity study. J Neurol Phys Ther. 2007 Mar;31(1):20-9. doi: 10.1097/01.npt.0000260567.24122.64.

  PMID: 17419886 BACKGROUND

• Malouin F, Richards CL, Doyon J, Desrosiers J, Belleville S. Training mobility tasks after stroke with combined mental and physical practice: a feasibility study. Neurorehabil Neural Repair. 2004 Jun;18(2):66-75. doi: 10.1177/0888439004266304.

  PMID: 15228801 BACKGROUND

• Malouin F, Richards CL, Durand A, Doyon J. Added value of mental practice combined with a small amount of physical practice on the relearning of rising and sitting post-stroke: a pilot study. J Neurol Phys Ther. 2009 Dec;33(4):195-202. doi: 10.1097/NPT.0b013e3181c2112b.

  PMID: 20208464 BACKGROUND

• Malouin F, Richards CL, Durand A, Doyon J. Clinical assessment of motor imagery after stroke. Neurorehabil Neural Repair. 2008 Jul-Aug;22(4):330-40. doi: 10.1177/1545968307313499. Epub 2008 Mar 6.

  PMID: 18326057 BACKGROUND

• Hesse S, Schauer M, Malezic M, Jahnke M, Mauritz KH. Quantitative analysis of rising from a chair in healthy and hemiparetic subjects. Scand J Rehabil Med. 1994 Sep;26(3):161-6.

  PMID: 7801066 BACKGROUND

• Decety J. The neurophysiological basis of motor imagery. Behav Brain Res. 1996 May;77(1-2):45-52. doi: 10.1016/0166-4328(95)00225-1.

  PMID: 8762158 BACKGROUND

• Dunsky A, Dickstein R, Marcovitz E, Levy S, Deutsch JE. Home-based motor imagery training for gait rehabilitation of people with chronic poststroke hemiparesis. Arch Phys Med Rehabil. 2008 Aug;89(8):1580-8. doi: 10.1016/j.apmr.2007.12.039.

  PMID: 18674992 BACKGROUND

• Braun S, Kleynen M, van Heel T, Kruithof N, Wade D, Beurskens A. The effects of mental practice in neurological rehabilitation; a systematic review and meta-analysis. Front Hum Neurosci. 2013 Aug 2;7:390. doi: 10.3389/fnhum.2013.00390. eCollection 2013.

  PMID: 23935572 BACKGROUND

• Ietswaart M, Johnston M, Dijkerman HC, Joice S, Scott CL, MacWalter RS, Hamilton SJ. Mental practice with motor imagery in stroke recovery: randomized controlled trial of efficacy. Brain. 2011 May;134(Pt 5):1373-86. doi: 10.1093/brain/awr077. Epub 2011 Apr 22.

  PMID: 21515905 BACKGROUND

• Guerra ZF, Bellose LC, Ferreira AP, Faria CDCM, Paz CCSC, Lucchetti G. Effects of mental practice on mobility of individuals in the early subacute post-stroke phase: A randomized controlled clinical trial. J Bodyw Mov Ther. 2022 Oct;32:82-90. doi: 10.1016/j.jbmt.2022.04.018. Epub 2022 Apr 27.

  PMID: 36180164 DERIVED

MeSH Terms

Conditions

Stroke; Paresis

Interventions

Cognitive Training

Condition Hierarchy (Ancestors)

Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Neurological Rehabilitation; Rehabilitation; Aftercare; Continuity of Patient Care; Patient Care; Therapeutics; Health Services; Health Care Facilities Workforce and Services

Study Officials

• Zaqueline F Guerra

  Federal University of Juiz de Fora

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: MSc

Study Record Dates

• First Submitted: September 1, 2015
• First Posted: September 3, 2015
• Study Start: November 1, 2015
• Primary Completion: January 1, 2019
• Study Completion: July 1, 2020
• Last Updated: May 23, 2019

Record last verified: 2019-05

Locations

BR (1)