Motor Imagery in Post-Stroke Dysphagia

NCT07656844 | Completed

• 1 other identifier: Motor Imagery
• Study Type: interventional
• Target: 43
• Locations: 1 country
• Sites: 1

Brief Summary

This study evaluated the effects of motor imagery added to conventional swallowing rehabilitation in patients with dysphagia after stroke. Dysphagia, or swallowing difficulty, is a common problem after stroke and may increase the risk of aspiration, pneumonia, malnutrition, dehydration, and reduced quality of life. Participants with post-stroke dysphagia were randomly assigned to one of three groups: video-assisted motor imagery, motor imagery alone, or control. All participants received conventional swallowing rehabilitation. In addition, the video-assisted motor imagery group watched videos showing swallowing-related actions and then mentally imagined the observed movement. The motor imagery alone group performed mental imagery of swallowing without visual stimulation. The control group received only conventional swallowing rehabilitation. The intervention period lasted 4 weeks, with sessions performed twice weekly. Swallowing function was assessed before and after treatment using the Gugging Swallowing Screen, the Penetration-Aspiration Scale based on videofluoroscopic swallowing study, and the Stroke Impact Scale. The aim of the study was to determine whether motor imagery, especially when supported by video observation, provides additional benefit for swallowing recovery in patients with post-stroke dysphagia.

Conditions

Post-stroke Dysphagia; Oropharyngeal Dysphagia (OPD)

Keywords

Stroke; Dysphagia; Post-stroke dysphagia; Oropharyngeal dysphagia; Motor imagery; Action observation; Swallowing rehabilitation; Videofluoroscopic swallowing study; Penetration-Aspiration Scale; Gugging Swallowing Screen

Outcome Measures

Primary Outcomes (1)

• Change in Penetration-Aspiration Scale Score

  Change in swallowing safety was assessed using the Penetration-Aspiration Scale based on videofluoroscopic swallowing study. The scale evaluates airway invasion during swallowing. Scores range from 1 to 8, with higher scores indicating greater penetration or aspiration severity. A decrease in score indicates improvement.

  Baseline and Week 4 (end of intervention)

Secondary Outcomes (2)

• Change in Gugging Swallowing Screen Score

  Baseline and Week 4 (end of intervention)

• Change in Stroke Impact Scale Score

  Baseline and Week 4 (end of intervention)

Study Arms (3)

Video-Assisted Motor Imagery Group

EXPERIMENTAL

Participants in this group received conventional dysphagia rehabilitation plus video-assisted motor imagery. They watched videos depicting swallowing-related actions and then mentally simulated the observed swallowing movement. The intervention was administered twice weekly for 4 weeks.

Behavioral: Video-Assisted Motor Imagery; Behavioral: Conventional Dysphagia Rehabilitation

Motor Imagery Alone Group

EXPERIMENTAL

Participants in this group received conventional dysphagia rehabilitation plus motor imagery training without visual stimulation. They were instructed to mentally imagine the swallowing movement. The intervention was administered twice weekly for 4 weeks.

Behavioral: Motor Imagery Training; Behavioral: Conventional Dysphagia Rehabilitation

Control Group

ACTIVE COMPARATOR

Participants in this group received conventional dysphagia rehabilitation alone. The rehabilitation program was administered twice weekly for 4 weeks.

Behavioral: Conventional Dysphagia Rehabilitation

Interventions

Video-Assisted Motor Imagery BEHAVIORAL

Participants watched videos showing swallowing-related actions and then performed motor imagery by mentally simulating the observed swallowing movement. This intervention was added to conventional dysphagia rehabilitation.

Video-Assisted Motor Imagery Group

Motor Imagery Training BEHAVIORAL

Participants performed mental imagery of swallowing without visual stimulation. This intervention was added to conventional dysphagia rehabilitation.

Motor Imagery Alone Group

Conventional Dysphagia Rehabilitation BEHAVIORAL

Conventional dysphagia rehabilitation included standard swallowing therapy approaches used in clinical practice, such as swallowing exercises, compensatory strategies, postural adjustments, and diet or consistency modifications when appropriate.

Control Group; Motor Imagery Alone Group; Video-Assisted Motor Imagery Group

Eligibility Criteria

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

You may qualify if:

• Age 18 years or older
• Diagnosis of stroke by a neurologist based on medical history, physical examination, and brain computed tomography and/or magnetic resonance imaging findings
• No progressive or non-progressive neurological disease other than stroke
• No known psychiatric disease
• No sensory dysfunction
• No communication problem
• Mini-Mental State Examination score of 24 or higher and ability to follow commands at a level sufficient to comply with motor imagery practice
• Ability to maintain sitting balance and remain in a sitting position for 30 minutes
• Presence of dysphagia symptoms or need for further evaluation based on dysphagia screening tests, with referral for videofluoroscopic swallowing study
• No serious acute medical condition such as hemodynamic instability during testing

You may not qualify if:

• Refusal to participate in the study or withdrawal from the study during the study period
• Inadequate performance of videofluoroscopic swallowing evaluation due to technical, clinical, or patient compliance-related reasons
• Presence of sensory-motor aphasia
• Presence of visual or hearing impairment
• Presence of severe neglect
• Evidence of esophageal dysphagia on videofluoroscopy and/or clinical symptoms
• History of surgery, cancer, or radiotherapy in the head and neck region that may affect swallowing
• Presence of vertebral problems that may restrict cervical movement, such as advanced cervical discopathy, prominent osteophyte formation, or cervical deformity
• Presence of neurological diseases other than stroke that may cause dysphagia, such as dementia, Parkinson disease, multiple sclerosis, or neuromuscular disease

Sponsors & Collaborators

• Ankara Etlik City Hospital: lead

Study Sites (1)

Ankara Etlik City Hospital, Physical Medicine and Rehabilitation Clinic

Ankara, Ankara, 06170, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Deglutition Disorders; Stroke

Condition Hierarchy (Ancestors)

Esophageal Diseases; Gastrointestinal Diseases; Digestive System Diseases; Pharyngeal Diseases; Otorhinolaryngologic Diseases; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases

Study Officials

• Gizem Karcı Aktekin, MD

  Ankara Etlik City Hospital, Physical Medicine and Rehabilitation Clinic

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: The study was designed as a single-blind trial. Outcome assessments were performed by an assessor who was blinded to group allocation.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Investigator / Principal Investigator

Model Details: Participants were randomly assigned to one of three parallel groups: video-assisted motor imagery plus conventional dysphagia rehabilitation, motor imagery alone plus conventional dysphagia rehabilitation, or conventional dysphagia rehabilitation alone.

Study Record Dates

• First Submitted: June 14, 2026
• First Posted: June 18, 2026
• Study Start: July 1, 2025
• Primary Completion: May 31, 2026
• Study Completion: May 31, 2026
• Last Updated: June 24, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)