Comparison of Embedded and Added Motor Imagery Training in Patients After Stroke

Study Overview
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Brief Summary
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The purpose of the study is to examine if patients in the embedded motor imagery (MI) training group (EG1) need less time to perform the motor task than patients in the added MI training group (EG2).

Detailed Description
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The purpose of the study is to examine if patients in the embedded MI training into physiotherapy (EG1) need less time to perform the motor task than patients in the added MI training to physiotherapy (EG2). A third groups serves a control group (CG) to investigate the effect of the intervention versus a group with a control intervention. Additionally, semi-structured interviews before and after the intervention will give an insight in the patient's experience with motor imagery (MI), their expectations regarding the intervention and their opinions about MI after the intervention.

Official Title
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Comparison of Embedded and Added Motor Imagery Training to Improve a Motor Skill in Patients After Stroke: a Pilot Randomised Controlled Trial Using a Mixed Methods Approach

Conditions
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Stroke

Intervention / Treatment
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* Other: Motor imagery (MI) training
* Other: Control intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients after a first-ever ischemic or hemorrhagic stroke Outpatients or leaving inpatients 3 months after stroke Ability to stand with or without a cane for at least 30 sec on a normal hard floor Ability to walk for 20 metres with or without a cane or an orthosis MMSE with at least 20 points Age older than 18 years Signed written informed consent Exclusion Criteria: Joint replacements (knee, hip, shoulder) Limiting pain in the upper or lower body Limiting range of motion (ROM) in the hip, knee, ankle joint or toes Body weight more than 90 kilograms Compromised mental capacity to give written informed consent

Ages Eligible for Study
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Minimum Age: 18 Years

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: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: EG1: embedded MI<br>Experimental group 1: Participants receive motor imagery (MI) training included in 45min physiotherapy, 3 times per week for 2 weeks. | Other: Motor imagery (MI) training<br>* MI training encloses the internal rehearsal of a known motor skill without any overt motor output.<br>|
| Experimental: EG2: added MI<br>Experimental group 2: Participants receive a 15 minutes motor imagery (MI) training added to a 30 min physiotherapy session, 3 times a week for two weeks. | Other: Motor imagery (MI) training<br>* MI training encloses the internal rehearsal of a known motor skill without any overt motor output.<br>|
| Placebo Comparator: CG<br>Control group: Participants receive a 15 min control intervention added to their 30 min physiotherapy session, 3 times a week for two weeks. | Other: Control intervention<br>* The control intervention encloses relaxation and breathing exercises, and information about: the disease (stroke), therapy options, self-help groups and their offers for support, helping aids for independent living at home.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time in seconds to perform a motor task: Going down, laying on the floor and getting up again. |  | 2 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Further outcome measures: - Help needed to perform the task, scored on a 7-item scale (1 total help, 7 completely independent) - Stage of motor task (one out of 13 possible stages) |  | 2 weeks | 
| Motor impairment and independence measured with the extended Barthel index (EBI). |  | 2 weeks | 
| Balance measured with the Berg Balance Scale (BBS). |  | 2 weeks | 
| Motor imagery ability measured with the kinesthetic and visual motor imagery questionnaire (KVIQ) and the 'Imaprax 1.1' software. |  | 2 weeks | 
| Fear of falling (FOF) is measured with the Activities-Specific Balance Confidence Scale (ABC-scale). |  | 2 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Motor imagery, Motor skill, Performance improvement