Recovery of Hand Function Through Mental Practice.

Study Overview
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Brief Summary
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The purpose of this study is to assess the therapeutic benefits of motor imagery training in stroke patients with persistent motor weakness.

Detailed Description
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Stroke is a common and highly debilitating illness. Many patients (41-45%) experience chronic motor impairments (Dijkerman et al., 1996) and limitations in activities of daily living (Wade & Langton Hewer, 1987) even after extensive neurological rehabilitation. They often result in long-term dependence at a considerable cost to the carers and the health service. It is therefore crucial to optimise motor recovery after stroke. This study investigates the therapeutic benefits of motor imagery training in stroke patients with a motor weakness. Evidence for the idea that motor imagery training could enhance the recovery of hand function comes from several separate bases of evidence: the sports literature; neurophysiological evidence; evidence from health psychology research; as well as preliminary findings using motor imagery techniques in stroke patients. There is evidence to suggest that mental rehearsal of movement can produce effects normally attributed to practising the actual movements. Imagining hand movements could stimulate the redistribution of brain activity, which accompanies recovery of hand function, thus resulting in a reduced motor deficit. Patients are assessed before and after a four-week evaluation period. In this randomised controlled trial 45 patients daily mentally rehearse movements with their affected hand under close supervision. Their recovery is compared to 45 patients who perform closely supervised non-motor mental rehearsal, and 45 patients who are not engaged in a training program.

Official Title
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Can Motor Imagery Enhance Recovery of Hand Function After Stroke? Evaluation of Motor Imagery Training.

Conditions
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Stroke

Intervention / Treatment
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* Behavioral: Mental Imagery


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Confirmed diagnosis of stroke in the last 1-6 months Persisting upper limb weakness - Exclusion Criteria: Alcohol/ Drug abuse Psychiatric history Previous illness that has impacted on individuals Activity of Daily living - Dementia (assessed by MSQ) Severe Aphasia
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: Double


Arms and Interventions

| Intervention/Treatment |
| --- |
|Behavioral: Mental Imagery|nan|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Action Research Arm Test (ARAT) (Lyle, 1981) |  |  | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Grip strength (dynamometer; Heller et al., 1987), |  |  | 
| Nine hole pegboard task (Mathiowetz et al., 1985, Wade [ref]), |  |  | 
| Function Limitation Profile |  |  | 
| Barthel Index |  |  | 
| Recovery Locus of Control |  |  | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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health psychology, Motor Imagery, Stroke, Neuro-rehabilitation, neuroscience, randomised controlled trial