Motor Imaging, Neglect, and Upper Extremity Function in Stroke

NCT07480122 | Not Yet Recruiting

• 1 other identifier: 2026/013
• Study Type: observational
• Target: 50
• Locations: 0 countries
• Sites: N/A

Brief Summary

This study aims to investigate the relationship between motor imagery skills and neglect level, upper extremity motor function, activities of daily living, quality of life, lateralization performance, and mental timer performance in individuals with stroke. Individuals with stroke who meet the inclusion criteria and voluntarily agree to participate will be evaluated. Demographic and clinical information of the participants will be recorded on an assessment form prepared by the researcher. Upper extremity motor functions will be assessed using the Fugl-Meyer Upper Extremity Motor Assessment Scale and the Wolf Motor Function Test; activities of daily living will be assessed using the Modified Barthel Index; and quality of life will be assessed using the Stroke-Specific Quality of Life Scale. Motor imagery skills will be measured using the Kinesthetic and Visual Imagery Questionnaire and a mental timer task; upper extremity lateralization performance will be assessed using the Recognise™ application. Neglect level will be assessed using the Catherine Bergego Scale, the Line Splitting Test, and the Star Erase Test. The data obtained will be statistically analyzed to examine the relationships between motor imagery skills and other clinical variables.

Conditions

Stroke; Neglect, Hemispatial; Motor ımargery; Upper Extremity Function; Daily Life Activity; Quality of Life

Outcome Measures

Primary Outcomes (6)

• Fugl-Meyer Upper Extremity Motor Assessment Scale

  Fugl-Meyer and colleagues developed the Fugl-Meyer Motor Assessment Scale in 1975 by expanding on Brunnstrom's motor assessment method. The scale is a widely used, reliable, and valid test for assessing paretic upper extremity motor impairment in stroke patients. The FM-UE is a 33-item sub-section of this scale. The scale evaluates the movement, coordination, and reflexes of the shoulder, elbow, forearm, wrist, and fingers. Each parameter is scored between 0 and 2 points, with a maximum score of 66, indicating good motor function. In tests evaluating upper extremity movement, the scoring is as follows: 0: movement cannot be performed, 1: movement is partially performed, and 2: movement is performed normally.

  6 mounth

• Kinesthetic and Visual Imagination Questionnaire (KVIQ)

  The KGIA will be used to evaluate motor imagery skills. The Turkish validity and reliability study of the scale developed by Malouin et al. was conducted by Dilek et al. The questionnaire, administered with the assistance of an evaluator, consists of 10 movements and assesses how well participants can visualize and feel the movements. Participants are first asked to perform the movement actually, and then to visually and kinesthetically imagine the same movement. The level of visual and kinesthetic imagery is scored between 1 (no image/feeling) and 5 (very clear/very intense), and visual and kinesthetic imagery scores are calculated at the end of the evaluation.

  6 mounth

• Catherine Bergego Scale

  It is a scale that assesses neglect syndrome by directly observing daily life. The 10-item scale was developed by Professor Philippe Azouvi (1996). The Turkish validity and reliability study was done by Kulaç et al.

  6 mounth

• Line Bisection Test

  The line-splitting test is one of the tests used in the clinical diagnosis of neglect syndrome. In this test, patients are presented with a sheet of paper printed on A4 paper, consisting of straight horizontal lines of varying lengths. These lines are positioned in the center, to the right, and to the left of the paper. The paper is placed in front of the patient, in the midline. In this test, the patient is asked to mark the midpoint of all the lines on the paper. Patients with neglect often mark the right side of the original center.

  6 mounth

• The Star Cancellation Test

  The Star Erase Test was developed in 1987 by Wilson, Cockburn, and Halligan. It consists of an A4-sized sheet of paper with randomly distributed small stars, large stars, words, and letters. In the Star Erase Test, there are 52 small stars interspersed among 52 large stars, 10 short words, and 13 letters. The paper is placed mid-line directly in front of the patient, and the patient is asked to mark the small stars. The maximum score is 54, as the two middle stars are marked as examples by the observer. A score of 51 or lower indicates visual inattention.

  6 mounth

• Wolf Motor Function Test

  The WMFT was developed by Wolf et al. to evaluate motor skills in patients with upper extremity motor dysfunction and was later modified by Morris et al. for use in patients with lower motor function. In this study, the modified WMFT will be used. The test consists of 17 tasks, including 2 muscle strength items and 15 functional activities. Functional activities are scored on a 0-5 scale, and the average score represents the functional ability score, with higher scores indicating better motor performance. Performance time for each task is also recorded, with a maximum time limit of 120 seconds per activity. Participants are instructed to perform each task as quickly as possible after the command "start. "

  6 mounth

Secondary Outcomes (4)

• Lateralization Assessment

  6 mounth

• Mental Cronometre Time

  6 mounth

• Stroke-Specific Quality of Life Scale

  6 mounth

• Modified Barthel Index

  6 mounth

Study Arms (1)

stroke group

The study population consists of stroke patients residing in Malatya province, and the sample comprises patients who have presented to a specialist physician with this complaint, received a stroke diagnosis, and applied to our clinic. Patients will be randomly selected from among those who consulted a physical medicine and rehabilitation specialist, had no contraindications indicated by the physician, agreed to participate voluntarily in the study, and met the study criteria. They will be evaluated using appropriate assessment methods.

Other: No intervention will be made; an assessment will be conducted.

Interventions

No intervention will be made; an assessment will be conducted. OTHER

No intervention will be made; an assessment will be conducted.

stroke group

Eligibility Criteria

• Age: 30 Years - 80 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

The study population consists of stroke patients residing in Malatya province, and the sample comprises patients who have presented to a specialist physician with this complaint, received a stroke diagnosis, and applied to our clinic. Patients who consult a physical medicine and rehabilitation specialist, have no contraindications indicated by the physician, voluntarily agree to participate in the study, and meet the study criteria will be randomly selected.

You may qualify if:

• Individuals who have experienced hemiplegia after an ischemic stroke,
• who actively use their right extremity according to the Edinburgh Hand Preference Questionnaire,
• who have right hemisphere involvement,
• who are 18 years of age or older,
• who have been diagnosed with a stroke at least 1 and at most 6 months ago,
• who have middle cerebral artery involvement,
• who have a Standardized Mini Mental Test score of 24 or higher,
• who are Stage 2b or higher according to Eggers staging,
• who can actively control their hand, wrist, and fingers and perform the release reflex,
• who wish to participate in the study voluntarily, and
• who have given their informed consent will be included in the research.

You may not qualify if:

• Individuals with major neurological, orthopedic, or rheumatological disorders affecting upper extremity function other than stroke (Polyneuropathy, Parkinson's Disease, Multiple Sclerosis, Rheumatoid Arthritis, etc.),
• Individuals with upper extremity amputation,
• Individuals with uncontrolled arrhythmia, uncontrolled hypertension, or unstable cardiac conditions,
• Individuals with active malignancy and receiving related chemo/radiotherapy,
• Individuals unable to cooperate due to aphasia or cognitive impairment,
• Individuals with visual and hearing problems,
• Individuals with communication problems that would hinder the evaluation and/or implementation of the treatment program,
• Individuals who are unable to undergo mental assessment, complete the scales, or are illiterate will be excluded from the study.

Sponsors & Collaborators

• Inonu University: lead

Related Publications (18)

• Albert SJ, Kesselring J. Neurorehabilitation of stroke. J Neurol. 2012 May;259(5):817-32. doi: 10.1007/s00415-011-6247-y. Epub 2011 Oct 1.

  PMID: 21964750 BACKGROUND

• Lai SM, Studenski S, Duncan PW, Perera S. Persisting consequences of stroke measured by the Stroke Impact Scale. Stroke. 2002 Jul;33(7):1840-4. doi: 10.1161/01.str.0000019289.15440.f2.

  PMID: 12105363 BACKGROUND

• Momosaki R, Yasunaga H, Kakuda W, Matsui H, Fushimi K, Abo M. Very Early versus Delayed Rehabilitation for Acute Ischemic Stroke Patients with Intravenous Recombinant Tissue Plasminogen Activator: A Nationwide Retrospective Cohort Study. Cerebrovasc Dis. 2016;42(1-2):41-8. doi: 10.1159/000444720. Epub 2016 Mar 18.

  PMID: 26986718 BACKGROUND

• Pollock A, Farmer SE, Brady MC, Langhorne P, Mead GE, Mehrholz J, van Wijck F. Interventions for improving upper limb function after stroke. Cochrane Database Syst Rev. 2014 Nov 12;2014(11):CD010820. doi: 10.1002/14651858.CD010820.pub2.

  PMID: 25387001 BACKGROUND

• Heilman KM, Valenstein E, Watson RT. Neglect and related disorders. Semin Neurol. 2000;20(4):463-70. doi: 10.1055/s-2000-13179.

  PMID: 11149702 BACKGROUND

• Kerkhoff G, Schenk T. Rehabilitation of neglect: an update. Neuropsychologia. 2012 May;50(6):1072-9. doi: 10.1016/j.neuropsychologia.2012.01.024. Epub 2012 Jan 28.

  PMID: 22306520 BACKGROUND

• Lotze M, Halsband U. Motor imagery. J Physiol Paris. 2006 Jun;99(4-6):386-95. doi: 10.1016/j.jphysparis.2006.03.012. Epub 2006 May 22.

  PMID: 16716573 BACKGROUND

• Daprati E, Nico D, Duval S, Lacquaniti F. Different motor imagery modes following brain damage. Cortex. 2010 Sep;46(8):1016-30. doi: 10.1016/j.cortex.2009.08.002. Epub 2009 Aug 13.

  PMID: 19726037 BACKGROUND

• Dickstein R, Deutsch JE. Motor imagery in physical therapist practice. Phys Ther. 2007 Jul;87(7):942-53. doi: 10.2522/ptj.20060331. Epub 2007 May 1.

  PMID: 17472948 BACKGROUND

• Mulder T. Motor imagery and action observation: cognitive tools for rehabilitation. J Neural Transm (Vienna). 2007;114(10):1265-78. doi: 10.1007/s00702-007-0763-z. Epub 2007 Jun 20.

  PMID: 17579805 BACKGROUND

• Fugl-Meyer AR, Jaasko L, Leyman I, Olsson S, Steglind S. The post-stroke hemiplegic patient. 1. a method for evaluation of physical performance. Scand J Rehabil Med. 1975;7(1):13-31.

  PMID: 1135616 BACKGROUND

• Okuyama K, Ogura M, Kawakami M, Tsujimoto K, Okada K, Miwa K, Takahashi Y, Abe K, Tanabe S, Yamaguchi T, Liu M. Effect of the combination of motor imagery and electrical stimulation on upper extremity motor function in patients with chronic stroke: preliminary results. Ther Adv Neurol Disord. 2018 Oct 9;11:1756286418804785. doi: 10.1177/1756286418804785. eCollection 2018.

  PMID: 30327684 BACKGROUND

• Gladstone DJ, Danells CJ, Black SE. The fugl-meyer assessment of motor recovery after stroke: a critical review of its measurement properties. Neurorehabil Neural Repair. 2002 Sep;16(3):232-40. doi: 10.1177/154596802401105171.

  PMID: 12234086 BACKGROUND

• Morris DM, Uswatte G, Crago JE, Cook EW 3rd, Taub E. The reliability of the wolf motor function test for assessing upper extremity function after stroke. Arch Phys Med Rehabil. 2001 Jun;82(6):750-5. doi: 10.1053/apmr.2001.23183.

  PMID: 11387578 BACKGROUND

• Wang YC, Chang PF, Chen YM, Lee YC, Huang SL, Chen MH, Hsieh CL. Comparison of responsiveness of the Barthel Index and modified Barthel Index in patients with stroke. Disabil Rehabil. 2023 Mar;45(6):1097-1102. doi: 10.1080/09638288.2022.2055166. Epub 2022 Mar 31.

  PMID: 35357990 BACKGROUND

• Kucukdeveci AA, Yavuzer G, Tennant A, Suldur N, Sonel B, Arasil T. Adaptation of the modified Barthel Index for use in physical medicine and rehabilitation in Turkey. Scand J Rehabil Med. 2000 Jun;32(2):87-92.

  PMID: 10853723 BACKGROUND

• Williams LS, Weinberger M, Harris LE, Clark DO, Biller J. Development of a stroke-specific quality of life scale. Stroke. 1999 Jul;30(7):1362-9. doi: 10.1161/01.str.30.7.1362.

  PMID: 10390308 BACKGROUND

• Candiri B, Talu B, Guner E, Ozen M. The effect of graded motor imagery training on pain, functional performance, motor imagery skills, and kinesiophobia after total knee arthroplasty: randomized controlled trial. Korean J Pain. 2023 Jul 1;36(3):369-381. doi: 10.3344/kjp.23020. Epub 2023 Jun 22.

  PMID: 37344366 BACKGROUND

MeSH Terms

Conditions

Stroke; Perceptual Disorders

Condition Hierarchy (Ancestors)

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

Central Study Contacts

HAVVA ADLI

CONTACT

05369831133; h.adli@hotmail.com

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: March 13, 2026
• First Posted: March 18, 2026
• Study Start: May 25, 2026
• Primary Completion: June 25, 2026
• Study Completion (Estimated): August 15, 2026
• Last Updated: May 22, 2026

Record last verified: 2026-05

Data Sharing

• IPD Sharing: Will not share