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Prasomsri J, Sakai K, Ikeda Y. Effectiveness of Motor Imagery on Physical Function in Patients With Stroke: A Systematic Review. Motor Control 2024:1-22. [PMID: 39069292 DOI: 10.1123/mc.2023-0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 04/23/2024] [Accepted: 04/30/2024] [Indexed: 07/30/2024]
Abstract
Over the past two decades, motor imagery (MI) has been used as a supplementary treatment approach to regain physical function in patients with stroke. However, the baseline treatment and the quality of study methodology for new treatment approaches have improved. This systematic review examined the evidence published in the past few decades on the effectiveness of MI on upper- and lower-extremity function and functional performance in patients with stroke. A total of 29 randomized controlled and crossover trials that compared MI with other interventions were analyzed. In addition, the outcomes were grouped into upper-, lower-extremity function, and functional performance for data analysis. More than half of the upper-extremity function studies reported improved performance in Fugl-Meyer assessment, Wolf motor function test, and box and block test in both acute and chronic stages. Lower-extremity function and functional performance were primarily investigated using Fugl-Meyer assessment, gait speed and parameters, activities of daily living, and balance ability. When considering only high-quality studies, six of 15 on upper extremity reported significant effects, whereas five of 15 reported nonsignificant effects. In addition, six of 14 studies on gait and balance reported significant effects. This systematic review suggests that both MI training and conventional rehabilitation programs effectively enhance upper limb functional abilities, including improvements in gait speed and balance, in individuals with acute and chronic stroke. Although the studies published during the past few decades showed heterogeneity in onset after stroke, research protocol, training intensity, and research methodology quality, none of them reported the long-term effects.
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Affiliation(s)
- Jaruwan Prasomsri
- Graduate School of Human Health Sciences, Department of Physical Therapy, Tokyo Metropolitan University, Tokyo, Japan
- Faculty of Medicine, Department of Physical Therapy, Prince of Songkla University, Songkhla, Thailand
| | - Katsuya Sakai
- Department of Physical Therapy, Faculty of Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
| | - Yumi Ikeda
- Graduate School of Human Health Sciences, Department of Physical Therapy, Tokyo Metropolitan University, Tokyo, Japan
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2
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Paolucci T, Agostini F, Mussomeli E, Cazzolla S, Conti M, Sarno F, Bernetti A, Paoloni M, Mangone M. A rehabilitative approach beyond the acute stroke event: a scoping review about functional recovery perspectives in the chronic hemiplegic patient. Front Neurol 2023; 14:1234205. [PMID: 37789885 PMCID: PMC10542412 DOI: 10.3389/fneur.2023.1234205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 08/14/2023] [Indexed: 10/05/2023] Open
Abstract
Background Stroke is a main cause of disability worldwide and its neuro-rehabilitative management is not limited to the acute phase but requires continuity in the rehabilitation approach especially in the chronic phase. The aim of this scoping review was to highlight the different treatment opportunities available in neurorehabilitation, effective for patients with chronic stroke sequelae, not only in terms of maintaining motor function but also improving it. Methods The literature search was conducted using the following databases: MEDLINE (PubMed), PEDro, Scopus, Web of Science (WOS), Cochrane from 2012 to February 2023. We selected Randomized Clinical Trials in English dealing with neurorehabilitation strategies in chronic hemiplegic patients after stroke focusing on motor function, muscular strength, gait, postural balance, spasticity, and quality of life. Results According to the inclusion criteria, 47 articles were selected for our review. All of them were analyzed following the primary outcome and the rehabilitation technique used. Despite the different protocols used within the same technique and despite the chronicity of the disease, all studies report an improvement after the rehabilitation treatment of motor function and quality of life. Conclusion The literature analyzed invites us to reflect respect to neurorehabilitation approach to the patient with chronic stroke sequelae often considered to have as its objective the maintenance of the present motor function and contain disability: instead, the review reports how, even in chronicity, the patient always reports margins of statistically and clinically significant improvement. The chronic stroke rehabilitation over 6 months has been proved effective in obtaining recovery in different settings.
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Affiliation(s)
- Teresa Paolucci
- Department of Medical, Oral and Biotechnological Science (DSMOB), University “G. d’Annunzio” of Chieti-Pescara, Chieti, Italy
| | - Francesco Agostini
- Department of Anatomy, Histology Forensic Medicine and Orthopedics, Sapienza University, Rome, Italy
| | - Elena Mussomeli
- Department of Anatomy, Histology Forensic Medicine and Orthopedics, Sapienza University, Rome, Italy
| | - Sara Cazzolla
- Department of Anatomy, Histology Forensic Medicine and Orthopedics, Sapienza University, Rome, Italy
| | - Marco Conti
- Department of Anatomy, Histology Forensic Medicine and Orthopedics, Sapienza University, Rome, Italy
| | - Francescapia Sarno
- Department of Medical, Oral and Biotechnological Science (DSMOB), University “G. d’Annunzio” of Chieti-Pescara, Chieti, Italy
| | - Andrea Bernetti
- Department of Anatomy, Histology Forensic Medicine and Orthopedics, Sapienza University, Rome, Italy
| | - Marco Paoloni
- Department of Anatomy, Histology Forensic Medicine and Orthopedics, Sapienza University, Rome, Italy
| | - Massimiliano Mangone
- Department of Anatomy, Histology Forensic Medicine and Orthopedics, Sapienza University, Rome, Italy
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Alenezi MM, Hayes A, Lawrence GP, Kubis HP. Influence of motor imagery training on hip abductor muscle strength and bilateral transfer effect. Front Physiol 2023; 14:1188658. [PMID: 37745234 PMCID: PMC10512955 DOI: 10.3389/fphys.2023.1188658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 08/22/2023] [Indexed: 09/26/2023] Open
Abstract
Motor imagery training could be an important treatment of reduced muscle function in patients and injured athletes. In this study, we investigated the efficacy of imagery training on maximal force production in a larger muscle group (hip abductors) and potential bilateral transfer effects. Healthy participants (n = 77) took part in two experimental studies using two imagery protocols (∼30 min/day, 5 days/week for 2 weeks) compared either with no practice (study 1), or with isometric exercise training (study 2). Maximal hip abduction isometric torque, electromyography amplitudes (trained and untrained limbs), handgrip strength, right shoulder abduction (strength and electromyography), and imagery capability were measured before and after the intervention. Post intervention, motor imagery groups of both studies exhibited significant increase in hip abductors strength (∼8%, trained side) and improved imagery capability. Further results showed that imagery training induced bilateral transfer effects on muscle strength and electromyography amplitude of hip abductors. Motor imagery training was effective in creating functional improvements in limb muscles of trained and untrained sides.
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Affiliation(s)
- Majid Manawer Alenezi
- Department of Sport and Exercise Sciences, School of Human and Behavioural Sciences, Bangor University, Bangor, United Kingdom
- Northern Border Health Cluster, Academic Affairs and Training, Arar, Saudi Arabia
| | - Amy Hayes
- Department of Sport and Exercise Sciences, School of Human and Behavioural Sciences, Bangor University, Bangor, United Kingdom
| | - Gavin P. Lawrence
- Department of Sport and Exercise Sciences, School of Human and Behavioural Sciences, Bangor University, Bangor, United Kingdom
| | - Hans-Peter Kubis
- Department of Sport and Exercise Sciences, School of Human and Behavioural Sciences, Bangor University, Bangor, United Kingdom
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Zhang H, Liu Q, Yao M, Zhang Z, Chen X, Luo H, Ruan L, Liu T, Chen Y, Ruan J. Neural oscillations during acupuncture imagery partially parallel that of real needling. Front Neurosci 2023; 17:1123466. [PMID: 37090802 PMCID: PMC10115979 DOI: 10.3389/fnins.2023.1123466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 03/20/2023] [Indexed: 04/25/2023] Open
Abstract
Introduction Tasks involving mental practice, relying on the cognitive rehearsal of physical motors or other activities, have been reported to have similar patterns of brain activity to overt execution. In this study, we introduced a novel imagination task called, acupuncture imagery and aimed to investigate the neural oscillations during acupuncture imagery. Methods Healthy volunteers were guided to watch a video of real needling in the left and right KI3 (Taixi point). The subjects were then asked to perform tasks to keep their thoughts in three 1-min states alternately: resting state, needling imagery left KI3, and needling imagery right KI3. Another group experienced real needling in the right KI3. A 31-channel-electroencephalography was synchronously recorded for each subject. Microstate analyses were performed to depict the brain dynamics during these tasks. Results Compared to the resting state, both acupuncture needling imagination and real needling in KI3 could introduce significant changes in neural dynamic oscillations. Moreover, the parameters involving microstate A of needling imagery in the right KI3 showed similar changes as real needling in the right KI3. Discussion These results confirm that needling imagination and real needling have similar brain activation patterns. Needling imagery may change brain network activity and play a role in neural regulation. Further studies are needed to explore the effects of acupuncture imagery and the potential application of acupuncture imagery in disease recovery.
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Affiliation(s)
- Hao Zhang
- Department of Neurology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Laboratory of Neurological Diseases and Brain Function, Luzhou, China
| | - Qingxia Liu
- Department of Neurology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Laboratory of Neurological Diseases and Brain Function, Luzhou, China
| | - Menglin Yao
- School of Integrated Traditional Chinese and Western Medicine, Southwest Medical University, Luzhou, China
| | - Zhiling Zhang
- School of Integrated Traditional Chinese and Western Medicine, Southwest Medical University, Luzhou, China
| | - Xiu Chen
- Department of Neurology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Laboratory of Neurological Diseases and Brain Function, Luzhou, China
| | - Hua Luo
- Department of Neurology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Laboratory of Neurological Diseases and Brain Function, Luzhou, China
| | - Lili Ruan
- Department of Neurology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Laboratory of Neurological Diseases and Brain Function, Luzhou, China
| | - Tianpeng Liu
- Shaanxi University of Chinese Medicine, Xianyang, China
| | - Yingshuang Chen
- School of Integrated Traditional Chinese and Western Medicine, Southwest Medical University, Luzhou, China
| | - Jianghai Ruan
- Department of Neurology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Laboratory of Neurological Diseases and Brain Function, Luzhou, China
- *Correspondence: Jianghai Ruan,
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Outdoor Community Ambulation Interventions to Improve Physical and Mental Health in Older Adults: A Systematic Review and Meta-Analysis. J Aging Phys Act 2022; 30:1061-1074. [PMID: 35418512 DOI: 10.1123/japa.2021-0151] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 01/19/2022] [Accepted: 02/01/2022] [Indexed: 11/18/2022]
Abstract
Limited community ambulation, defined as independent mobility outside the home, predicts adverse outcomes in older adults. We performed a systematic review and meta-analysis to examine outdoor community ambulation intervention effectiveness in older adults. We searched six databases until October 2021. Studies with an evaluative research objective, older adult population, and outdoor community ambulation interventions were eligible. After reviewing 23,172 records, five studies were included. The meta-analysis found no significant difference in walking endurance and depression outcomes between outdoor community ambulation and comparison interventions. For outcomes not suitable for meta-analysis, studies showed no significant difference in walking activity, anxiety, and general and health-related quality of life, and possible improvements in gait speed and lower extremity function and strength. Most evidence was of low to very low certainty. Considering the limited evidence base, the design, implementation, and evaluation of outdoor community ambulation interventions in older adults should be prioritized in primary research.
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Guerra ZF, Bellose LC, Ferreira AP, Faria CD, Paz CC, 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; 32:82-90. [DOI: 10.1016/j.jbmt.2022.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 04/04/2022] [Accepted: 04/24/2022] [Indexed: 10/18/2022]
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Cuomo G, Maglianella V, Ghanbari Ghooshchy S, Zoccolotti P, Martelli M, Paolucci S, Morone G, Iosa M. Motor imagery and gait control in Parkinson's disease: techniques and new perspectives in neurorehabilitation. Expert Rev Neurother 2021; 22:43-51. [PMID: 34906019 DOI: 10.1080/14737175.2022.2018301] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Motor imagery (MI), defined as the ability to mentally represent an action without actual movement, has been used to improve motor function in athletes and, more recently, in neurological disorders such as Parkinson's disease (PD). Several studies have investigated the neural correlates of motor imagery, which change also depending on the action imagined. AREAS COVERED This review focuses on locomotion, which is a crucial activity in everyday life and is often impaired by neurological conditions. After a general discussion on the neural correlates of motor imagery and locomotion, we review the evidence highlighting the abnormalities in gait control and gait imagery in PD patients. Next, new perspectives and techniques for PD patients' rehabilitation are discussed, namely Brain Computer Interfaces (BCIs), neurofeedback, and virtual reality (VR). EXPERT OPINION Despite the few studies, the literature review supports the potential beneficial effects of motor imagery interventions in PD focused on locomotion. The development of new technologies could empower the administration of training based on motor imagery locomotor tasks, and their application could lead to new rehabilitation protocols aimed at improving walking ability in patients with PD.
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Affiliation(s)
- Giovanna Cuomo
- Department of Psychology, University of Rome "Sapienza", Rome, Italy
| | | | - Sheida Ghanbari Ghooshchy
- Department of Psychology, University of Rome "Sapienza", Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Pierluigi Zoccolotti
- Department of Psychology, University of Rome "Sapienza", Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Marialuisa Martelli
- Department of Psychology, University of Rome "Sapienza", Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
| | | | | | - Marco Iosa
- Department of Psychology, University of Rome "Sapienza", Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
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Paci M, Prestera C, Ferrarello F. Generalizability of Results from Randomized Controlled Trials in Post-Stroke Physiotherapy. Physiother Can 2020; 72:382-393. [PMID: 35110812 PMCID: PMC8781507 DOI: 10.3138/ptc-2018-0117] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
Purpose: The randomized controlled trial (RCT) is considered a reliable experimental design, able to detect the effect of an intervention. However, a criticism frequently levelled at RCTs by clinicians is their lack of generalizability. This study aimed to evaluate the generalizability of findings from RCTs of physiotherapy interventions for individuals with stroke. Method: A sample of RCTs of physiotherapy interventions after stroke indexed in the PEDro database was selected, and the reported inclusion and exclusion criteria were analyzed. Results: We reviewed 100 articles, which included 7,366 participants (41.6% women, with a mean weighted age of 65.5 years). The most frequent criteria for exclusion were comorbidity (83%), cognitive impairments (69%), communication skills (55%), recurrent stroke (53%), low functional level (47%) and being elderly (25%). Conclusions: A variety of cohorts of individuals who have had a stroke are excluded from RCTs published in the field of physiotherapy. Because they represent a substantial proportion of the real-world population with stroke, and consequently treated in clinical practice, more vulnerable cohorts of participants should be included in RCTs.
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Affiliation(s)
- Matteo Paci
- Unit of Functional Recovery, Azienda USL Toscana Centro, Florence
| | - Claudia Prestera
- Rehabilitation Center, Fondazione Filippo Turati Onlus, Gavinana, Pistoia, Italy
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Silva S, Borges LR, Santiago L, Lucena L, Lindquist AR, Ribeiro T. Motor imagery for gait rehabilitation after stroke. Cochrane Database Syst Rev 2020; 9:CD013019. [PMID: 32970328 PMCID: PMC8094749 DOI: 10.1002/14651858.cd013019.pub2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Motor imagery (MI) is defined as a mentally rehearsed task in which movement is imagined but is not performed. The approach includes repetitive imagined body movements or rehearsing imagined acts to improve motor performance. OBJECTIVES To assess the treatment effects of MI for enhancing ability to walk among people following stroke. SEARCH METHODS We searched the Cochrane Stroke Group registry, CENTRAL, MEDLINE, Embase and seven other databases. We also searched trial registries and reference lists. The last searches were conducted on 24 February 2020. SELECTION CRITERIA Randomized controlled trials (RCTs) using MI alone or associated with action observation or physical practice to improve gait in individuals after stroke. The critical outcome was the ability to walk, assessed using either a continuous variable (walking speed) or a dichotomous variable (dependence on personal assistance). Important outcomes included walking endurance, motor function, functional mobility, and adverse events. DATA COLLECTION AND ANALYSIS Two review authors independently selected the trials according to pre-defined inclusion criteria, extracted the data, assessed the risk of bias, and applied the GRADE approach to evaluate the certainty of the evidence. The review authors contacted the study authors for clarification and missing data. MAIN RESULTS We included 21 studies, involving a total of 762 participants. Participants were in the acute, subacute, or chronic stages of stroke, and had a mean age ranging from 50 to 78 years. All participants presented at least some gait deficit. All studies compared MI training versus other therapies. Most of the included studies used MI associated with physical practice in the experimental groups. The treatment time for the experimental groups ranged from two to eight weeks. There was a high risk of bias for at least one assessed domain in 20 of the 21 included studies. Regarding our critical outcome, there was very low-certainty evidence that MI was more beneficial for improving gait (walking speed) compared to other therapies at the end of the treatment (pooled standardized mean difference (SMD) 0.44; 95% confidence interval (CI) 0.06 to 0.81; P = 0.02; six studies; 191 participants; I² = 38%). We did not include the outcome of dependence on personal assistance in the meta-analysis, because only one study provided information regarding the number of participants that became dependent or independent after interventions. For our important outcomes, there was very low-certainty evidence that MI was no more beneficial than other interventions for improving motor function (pooled mean difference (MD) 2.24, 95% CI -1.20 to 5.69; P = 0.20; three studies; 130 participants; I² = 87%) and functional mobility at the end of the treatment (pooled SMD 0.55, 95% CI -0.45 to 1.56; P = 0.09; four studies; 116 participants; I² = 64.2%). No adverse events were observed in those studies that reported this outcome (seven studies). We were unable to pool data regarding walking endurance and all other outcomes at follow-up. AUTHORS' CONCLUSIONS We found very low-certainty evidence regarding the short-term benefits of MI on walking speed in individuals who have had a stroke, compared to other therapies. Evidence was insufficient to estimate the effect of MI on the dependence on personal assistance and walking endurance. Compared with other therapies, the evidence indicates that MI does not improve motor function and functional mobility after stroke (very low-certainty evidence). Evidence was also insufficient to estimate the effect of MI on gait, motor function, and functional mobility after stroke compared to placebo or no intervention. Motor Imagery and other therapies used for gait rehabilitation after stroke do not appear to cause significant adverse events.
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Affiliation(s)
- Stephano Silva
- Department of Physical Therapy, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Lorenna Rdm Borges
- Department of Physical Therapy, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Lorenna Santiago
- Department of Physical Therapy, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Larissa Lucena
- Department of Physical Therapy, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Ana R Lindquist
- Department of Physical Therapy, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Tatiana Ribeiro
- Department of Physical Therapy, Federal University of Rio Grande do Norte, Natal, Brazil
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Chen J, Kan W, Liu Y, Hu X, Wu T, Zou Y, Liu H, Yang K. Frequency-specific equivalence of brain activity on motor imagery during action observation and action execution. Int J Neurosci 2020; 131:599-608. [PMID: 32228346 DOI: 10.1080/00207454.2020.1750394] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Human motor imagery (MI), action execution, and action observation (AO) are functionally considered as equivalent. MI during AO can extensively induce activation of motor-related brain network in the absence of overt movement. The magnetoencephalography (MEG) provides an important technology to reveal and reflect human brain information processing in multi-frequency bands. Utilizing a MEG system, we aimed to quantitatively investigate the frequency-specific equivalent characteristics in brain processing patterns between MI during AO and action execution in multi-frequency bands, including delta, theta, alpha, beta, gamma, and high-frequency oscillations. METHODS A total of 12 healthy subjects were studied with a whole-head MEG system during finger movement and MI during finger movement observation. We analyzed the brain activities in multi-frequency ranges of 1 Hz to 200 Hz. RESULTS Both MI during AO and action execution evoked the distinctive brain activities in low frequency ranges (i.e. delta, theta, and alpha). Significant differences were found in global spectral power between finger movement and MI during AO in delta and alpha oscillations. Compared with finger movement, delta (1-4 Hz) oscillation power in MI during AO were obviously decreased in left and right frontals and occipitals, and theta (4-8 Hz) and alpha (8-13 Hz) oscillation power were obviously increased in frontal, parietal and occipital. CONCLUSION MEG power evoked by finger movement and MI during AO is mainly concentrated in the energy distribution below 13 Hz. Furthermore, finger movement and MI during AO might share frequency-specific equivalence of brain neural activation dependent on different MEG frequency ranges.
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Affiliation(s)
- Jiu Chen
- Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Fourth Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China.,Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Wenwu Kan
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yong Liu
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xinhua Hu
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Ting Wu
- MEG Center, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yuanjie Zou
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hongyi Liu
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Kun Yang
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
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Quinton ML, Veldhuijzen van Zanten J, Trotman GP, Cumming J, Williams SE. Investigating the Protective Role of Mastery Imagery Ability in Buffering Debilitative Stress Responses. Front Psychol 2019; 10:1657. [PMID: 31396128 PMCID: PMC6668598 DOI: 10.3389/fpsyg.2019.01657] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 07/01/2019] [Indexed: 11/13/2022] Open
Abstract
Mastery imagery has been shown to be associated with more positive cognitive and emotional responses to stress, but research is yet to investigate the influence of mastery imagery ability on imagery's effectiveness in regulating responses to acute stress, such as competition. Furthermore, little research has examined imagery's effectiveness in response to actual competition. This study examined (a) whether mastery imagery ability was associated with stress response changes to a competitive stress task, a car racing computer game, following an imagery intervention, and (b) the effects of different guided imagery content on pre-task cognitive and emotional responses. In Session 1, 78 participants (M age = 20.03 years, SD = 1.28) completed ratings of pre-task anxiety intensity and direction, confidence, and perceived control. Imagery ability was also assessed before completing the task. In Session 2, participants were randomly allocated to an imagery condition (positive mastery, negative mastery, relaxation) or control group (no imagery) before completing the task and outcome measures again. For the negative mastery group, greater positive mastery imagery ability was associated with greater perceived control and perceiving anxiety as more facilitative. Furthermore, mastery imagery ability moderated the relationship between anxiety intensity and direction. Altogether, results suggest that positive mastery imagery ability may act as a potential buffer against the effects of negative images.
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12
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Guerra ZF, Bellose LC, Coelho de Morais Faria CD, Lucchetti G. The effects of mental practice based on motor imagery for mobility recovery after subacute stroke: Protocol for a randomized controlled trial. Complement Ther Clin Pract 2018; 33:36-42. [PMID: 30396624 DOI: 10.1016/j.ctcp.2018.08.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 06/25/2018] [Accepted: 08/05/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND PURPOSE Mental practice of motor imagery has shown beneficial effects in stroke recovery. However, there are few clinical trials investigating it on the subacute phase. This study will investigate the effects of mental practice in the mobility of patients with subacute stroke. MATERIALS AND METHODS Randomized controlled trial including persons with subacute stroke (<3 months). All participants will receive physical exercises and will be randomly allocated into an experimental group (Mental Practice) or into a control group (cognitive training) for 4 weeks(12 sessions). RESULTS Primary outcomes will be assessed at baseline and after intervention and will be related to mobility, using Timed Up and Go test and 5 m walking speed test. Whereas secondary outcomes will be muscular strength, biomechanical strategies, mental health and quality of life. CONCLUSION The beneficial effects that may be found in this trial can be greatly relevant in clinical practice, justifying this scientific question.
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Affiliation(s)
- Zaqueline Fernandes Guerra
- Post Graduation Health Program, Federal University of Juiz de Fora, Faculdade de Ciências Médicas e da Saúde de Juiz de Fora (SUPREMA) and UNIVERSO - Universidade Salgado de Oliveira, Brazil
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Alves SS, Ocamoto GN, de Camargo PS, Santos ATS, Terra AMSV. Effects of virtual reality and motor imagery techniques using Fugl Meyer Assessment scale in post-stroke patients. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2018. [DOI: 10.12968/ijtr.2018.25.11.587] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Suélen Santos Alves
- Physiotherapist, Neurofunctional Physical Therapy Laboratory, Federal University of Alfenas, Alfenas, Minas Gerais, Brazil
| | - Gabriela Nagai Ocamoto
- Physiotherapist, Neurofunctional Physical Therapy Laboratory, Federal University of Alfenas, Alfenas, Minas Gerais, Brazil
| | - Patrícia Silva de Camargo
- Physiotherapist, Neurofunctional Physical Therapy Laboratory, Federal University of Alfenas, Alfenas, Minas Gerais, Brazil
| | - Adriana Teresa Silva Santos
- Teacher, Neurofunctional Physical Therapy Laboratory, Federal University of Alfenas, Alfenas, Minas Gerais, Brazil
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Nakano H, Kodama T, Ukai K, Kawahara S, Horikawa S, Murata S. Reliability and Validity of the Japanese Version of the Kinesthetic and Visual Imagery Questionnaire (KVIQ). Brain Sci 2018; 8:brainsci8050079. [PMID: 29724042 PMCID: PMC5977070 DOI: 10.3390/brainsci8050079] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 04/27/2018] [Accepted: 04/29/2018] [Indexed: 12/24/2022] Open
Abstract
In this study, we aimed to (1) translate the English version of the Kinesthetic and Visual Imagery Questionnaire (KVIQ), which assesses motor imagery ability, into Japanese, and (2) investigate the reliability and validity of the Japanese KVIQ. We enrolled 28 healthy adults in this study. We used Cronbach’s alpha coefficients to assess reliability reflected by the internal consistency. Additionally, we assessed validity reflected by the criterion-related validity between the Japanese KVIQ and the Japanese version of the Movement Imagery Questionnaire-Revised (MIQ-R) with Spearman’s rank correlation coefficients. The Cronbach’s alpha coefficients for the KVIQ-20 were 0.88 (Visual) and 0.91 (Kinesthetic), which indicates high reliability. There was a significant positive correlation between the Japanese KVIQ-20 (Total) and the Japanese MIQ-R (Total) (r = 0.86, p < 0.01). Our results suggest that the Japanese KVIQ is an assessment that is a reliable and valid index of motor imagery ability.
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Affiliation(s)
- Hideki Nakano
- Department of Physical Therapy, Faculty of Health Science, Kyoto Tachibana University, 34 Yamada-cho, Oyake, Yamashina-ku, Kyoto-city, Kyoto 607-8175, Japan.
| | - Takayuki Kodama
- Department of Physical Therapy, Faculty of Health Science, Kyoto Tachibana University, 34 Yamada-cho, Oyake, Yamashina-ku, Kyoto-city, Kyoto 607-8175, Japan.
| | - Kazumasa Ukai
- Department of Physical Therapy, Faculty of Health Science, Kyoto Tachibana University, 34 Yamada-cho, Oyake, Yamashina-ku, Kyoto-city, Kyoto 607-8175, Japan.
| | - Satoru Kawahara
- Department of Physical Therapy, Faculty of Health Science, Kyoto Tachibana University, 34 Yamada-cho, Oyake, Yamashina-ku, Kyoto-city, Kyoto 607-8175, Japan.
| | - Shiori Horikawa
- Department of Physical Therapy, Faculty of Health Science, Kyoto Tachibana University, 34 Yamada-cho, Oyake, Yamashina-ku, Kyoto-city, Kyoto 607-8175, Japan.
| | - Shin Murata
- Department of Physical Therapy, Faculty of Health Science, Kyoto Tachibana University, 34 Yamada-cho, Oyake, Yamashina-ku, Kyoto-city, Kyoto 607-8175, Japan.
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Liu TW, Ng GYF, Ng SSM. Effectiveness of a combination of cognitive behavioral therapy and task-oriented balance training in reducing the fear of falling in patients with chronic stroke: study protocol for a randomized controlled trial. Trials 2018; 19:168. [PMID: 29514677 PMCID: PMC5842580 DOI: 10.1186/s13063-018-2549-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 02/15/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The consequences of falls are devastating for patients with stroke. Balance problems and fear of falling are two major challenges, and recent systematic reviews have revealed that habitual physical exercise training alone cannot reduce the occurrence of falls in stroke survivors. However, recent trials with community-dwelling healthy older adults yielded the promising result that interventions with a cognitive behavioral therapy (CBT) component can simultaneously promote balance and reduce the fear of falling. Therefore, the aim of the proposed clinical trial is to evaluate the effectiveness of a combination of CBT and task-oriented balance training (TOBT) in promoting subjective balance confidence, and thereby reducing fear-avoidance behavior, improving balance ability, reducing fall risk, and promoting independent living, community reintegration, and health-related quality of life of patients with stroke. METHODS The study will constitute a placebo-controlled single-blind parallel-group randomized controlled trial in which patients are assessed immediately, at 3 months, and at 12 months. The selected participants will be randomly allocated into one of two parallel groups (the experimental group and the control group) with a 1:1 ratio. Both groups will receive 45 min of TOBT twice per week for 8 weeks. In addition, the experimental group will receive a 45-min CBT-based group intervention, and the control group will receive 45 min of general health education (GHE) twice per week for 8 weeks. The primary outcome measure is subjective balance confidence. The secondary outcome measures are fear-avoidance behavior, balance ability, fall risk, level of activities of daily living, community reintegration, and health-related quality of life. DISCUSSION The proposed clinical trial will compare the effectiveness of CBT combined with TOBT and GHE combined with TOBT in promoting subjective balance confidence among chronic stroke patients. We hope our results will provide evidence of a safe, cost-effective, and readily transferrable therapeutic approach to clinical practice that reduces fear-avoidance behavior, improves balance ability, reduces fall risk, promotes independence and community reintegration, and enhances health-related quality of life. TRIAL REGISTRATION ClinicalTrials.gov, NCT02937532 . Registered on 17 October 2016.
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Affiliation(s)
- Tai-Wa Liu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, Special Administrative Region of China
- Division of Nursing and Health Studies, The Open University of Hong Kong, Ho Man Tin, Hong Kong, Special Administrative Region of China
| | - Gabriel Y. F. Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, Special Administrative Region of China
| | - Shamay S. M. Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, Special Administrative Region of China
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16
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Blumen HM, Verghese J. Motor imagery of walking and walking while talking: a pilot randomized-controlled trial protocol for older adults. Neurodegener Dis Manag 2017; 7:353-363. [PMID: 29165011 PMCID: PMC5941713 DOI: 10.2217/nmt-2017-0024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 08/09/2017] [Indexed: 12/31/2022] Open
Abstract
Over a third of community-residing elderly have clinical gait abnormalities, and gait impairment is associated with morbidity, mortality and dementia. Motor imagery - envisioning motor actions without actual execution - has been used to improve gait in Parkinson's disease and poststroke, but the efficacy of motor imagery in healthy elderly is unknown. This single-blind pilot randomized-controlled trial aims to establish feasibility and explore the efficacy of a 3-month, telephone-based motor imagery intervention - that involves imagined walking, imagined talking and imagined walking while talking for improving gait in 48 healthy elderly. The primary outcomes will be gait speed during actual walking and walking while talking. Secondary outcomes will include cognitive performance during actual talking and walking while talking, and functional neuroplasticity during imagined walking and walking while talking. This clinical trial has been registered on clinicaltrials.gov (identifier NCT02762604).
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Affiliation(s)
- Helena M Blumen
- Departments of Medicine & Neurology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Joe Verghese
- Departments of Medicine & Neurology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
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Motor Imagery Training After Stroke: A Systematic Review and Meta-analysis of Randomized Controlled Trials. J Neurol Phys Ther 2017; 41:205-214. [DOI: 10.1097/npt.0000000000000200] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Oh DS, Choi JD. The effect of motor imagery training for trunk movements on trunk muscle control and proprioception in stroke patients. J Phys Ther Sci 2017; 29:1224-1228. [PMID: 28744053 PMCID: PMC5509597 DOI: 10.1589/jpts.29.1224] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 04/27/2017] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The present study was conducted to evaluate the effect of motor imagery
training for trunk movements on trunk muscle control and proprioception in stroke
patients. [Subjects and Methods] A total of 12 study subjects were randomly assigned to
the experimental group (a motor imagery training group) and the control group (a
neurodevelopmental treatment, NDT) group. The two groups were treated five times (30
minutes each time) per week for 4 weeks. The experimental group underwent imagery training
for 10 minutes and trunk control centered NDT for 20 minutes and the control group
underwent only trunk control centered NDT for 30 minutes. The trunk muscle activity and
the position sense of the subjects were evaluated before and after the intervention.
[Results] The two groups showed significant improvements in muscle activity after the
intervention. Only the experimental group showed significant improvements in
proprioception. The experimental group showed significant improvements in the variations
of muscle activity and proprioception compared to the control group. [Conclusion] Motor
imagery training for trunk movements can be effectively used to improve trunk muscle
activity and proprioception in stroke patients.
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Affiliation(s)
- Dong-Sik Oh
- Department of Physical Therapy, Hanseo University, Republic of Korea
| | - Jong-Duk Choi
- Department of Physical Therapy, College of Health and Medical Science, Daejeon University, Republic of Korea
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Tong Y, Pendy JT, Li WA, Du H, Zhang T, Geng X, Ding Y. Motor Imagery-Based Rehabilitation: Potential Neural Correlates and Clinical Application for Functional Recovery of Motor Deficits after Stroke. Aging Dis 2017; 8:364-371. [PMID: 28580191 PMCID: PMC5440115 DOI: 10.14336/ad.2016.1012] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 10/12/2016] [Indexed: 01/01/2023] Open
Abstract
Motor imagery (MI), defined as the mental implementation of an action in the absence of movement or muscle activation, is a rehabilitation technique that offers a means to replace or restore lost motor function in stroke patients when used in conjunction with conventional physiotherapy procedures. This article briefly reviews the concepts and neural correlates of MI in order to promote improved understanding, as well as to enhance the clinical utility of MI-based rehabilitation regimens. We specifically highlight the role of the cerebellum and basal ganglia, premotor, supplementary motor, and prefrontal areas, primary motor cortex, and parietal cortex. Additionally, we examine the recent literature related to MI and its potential as a therapeutic technique in both upper and lower limb stroke rehabilitation.
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Affiliation(s)
- Yanna Tong
- China-America Institute of Neuroscience, Luhe Hospital, Capital Medical University, Beijing, China
- Department of Neurology, Luhe Hospital, Capital Medical University, Beijing, China
| | - John T. Pendy
- Department of Neurosurgery, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - William A. Li
- Department of Neurosurgery, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Huishan Du
- China-America Institute of Neuroscience, Luhe Hospital, Capital Medical University, Beijing, China
- Department of Neurology, Luhe Hospital, Capital Medical University, Beijing, China
| | - Tong Zhang
- China Rehabilitation Research Center, Capital Medical University, Beijing, China
| | - Xiaokun Geng
- China-America Institute of Neuroscience, Luhe Hospital, Capital Medical University, Beijing, China
- Department of Neurology, Luhe Hospital, Capital Medical University, Beijing, China
- Department of Neurosurgery, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Yuchuan Ding
- China-America Institute of Neuroscience, Luhe Hospital, Capital Medical University, Beijing, China
- Department of Neurosurgery, Wayne State University School of Medicine, Detroit, Michigan, USA
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20
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Kafri M, Dickstein R. External validity of post-stroke interventional gait rehabilitation studies. Top Stroke Rehabil 2016; 24:61-67. [PMID: 27145119 DOI: 10.1080/10749357.2016.1176796] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Gait rehabilitation is a major component of stroke rehabilitation, and is supported by extensive research. The objective of this review was to examine the external validity of intervention studies aimed at improving gait in individuals post-stroke. To that end, two aspects of these studies were assessed: subjects' exclusion criteria and the ecological validity of the intervention, as manifested by the intervention's technological complexity and delivery setting. Additionally, we examined whether the target population as inferred from the titles/abstracts is broader than the population actually represented by the reported samples. METHODS We systematically researched PubMed for intervention studies to improve gait post-stroke, working backwards from the beginning of 2014. Exclusion criteria, the technological complexity of the intervention (defined as either elaborate or simple), setting, and description of the target population in the titles/abstracts were recorded. RESULTS Fifty-two studies were reviewed. The samples were exclusive, with recurrent stroke, co-morbidities, cognitive status, walking level, and residency being major reasons for exclusion. In one half of the studies, the intervention was elaborate. Descriptions of participants in the title/abstract in almost one half of the studies included only the diagnosis (stroke or comparable terms) and its stage (acute, subacute, and chronic). CONCLUSIONS The external validity of a substantial number of intervention studies about rehabilitation of gait post-stroke appears to be limited by exclusivity of the samples as well as by deficiencies in ecological validity of the interventions. These limitations are not accurately reflected in the titles or abstracts of the studies.
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Affiliation(s)
- Michal Kafri
- a Department of Physical Therapy , Faculty of Social Welfare & Health Sciences , University of Haifa , Haifa , Israel
| | - Ruth Dickstein
- a Department of Physical Therapy , Faculty of Social Welfare & Health Sciences , University of Haifa , Haifa , Israel
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Tang A, Tao A, Soh M, Tam C, Tan H, Thompson J, Eng JJ. The effect of interventions on balance self-efficacy in the stroke population: a systematic review and meta-analysis. Clin Rehabil 2015; 29:1168-77. [PMID: 25681409 PMCID: PMC4596690 DOI: 10.1177/0269215515570380] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 12/27/2014] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To conduct a systematic review of clinical trials that examined the effectiveness of interventions on balance self-efficacy among individuals with stroke. DESIGN Systematic review. SUMMARY OF REVIEW Searches of the following databases were completed in December 2014: MEDLINE (1948-present), CINAHL (1982-present), EMBASE (1980-present) and PsycINFO (1987-present) for controlled clinical trials that measured balance self-efficacy in adults with stroke. Reference lists of selected articles were hand-searched to identify further relevant studies. REVIEW METHODS Two independent reviewers performed data extraction and assessed the methodological quality of the studies using the Physical Therapy Evidence Database Scale. Standardized mean differences (SMD) were calculated. RESULTS A total of 19 trials involving 729 participants used balance self-efficacy as a secondary outcome. Study quality ranged from poor (n = 3) to good (n = 8). In the meta-analysis of 15 trials that used intensive physical activity interventions, a moderate beneficial effect on balance self-efficacy was observed immediately following the programs (SMD 0.44, 95% CI 0.11-0.77, P = 0.009). In the studies that included follow-up assessments, there was no difference between groups across retention periods (eight studies, SMD 0.32, 95% CI -0.17-0.80, P = 0.20). In the four studies that used motor imagery interventions, there was no between-group difference in change in balance self-efficacy (fixed effects SMD 0.68, 95% CI -0.33-1.69, P = 0.18). CONCLUSIONS Physical activity interventions appear to be effective in improving balance self-efficacy after stroke.
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Affiliation(s)
- Ada Tang
- McMaster University School of Rehabilitation Science Population Health Research Institute, Hamilton, Canada Canadian Partnership for Stroke Recovery, Ottawa, Canada
| | - Amy Tao
- Department of Physical Therapy, University of British Columbia, Faculty of Medicine, Vancouver, Canada
| | - Michelle Soh
- Department of Physical Therapy, University of British Columbia, Faculty of Medicine, Vancouver, Canada
| | - Carolyn Tam
- Department of Physical Therapy, University of British Columbia, Faculty of Medicine, Vancouver, Canada
| | - Hannah Tan
- Department of Physical Therapy, University of British Columbia, Faculty of Medicine, Vancouver, Canada
| | - Jessica Thompson
- Department of Physical Therapy, University of British Columbia, Faculty of Medicine, Vancouver, Canada
| | - Janice J Eng
- Canadian Partnership for Stroke Recovery, Ottawa, Canada Department of Physical Therapy, University of British Columbia, Faculty of Medicine, Vancouver, Canada Vancouver Coastal Health, Vancouver, Canada International Collaboration on Repair Discoveries, Vancouver, Canada
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22
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Rulleau T, Mauvieux B, Toussaint L. Influence of Circadian Rhythms on the Temporal Features of Motor Imagery for Older Adult Inpatients. Arch Phys Med Rehabil 2015; 96:1229-34. [DOI: 10.1016/j.apmr.2015.02.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 02/12/2015] [Accepted: 02/17/2015] [Indexed: 11/25/2022]
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Barclay RE, Stevenson TJ, Poluha W, Ripat J, Nett C, Srikesavan CS. Interventions for improving community ambulation in individuals with stroke. Cochrane Database Syst Rev 2015; 2015:CD010200. [PMID: 25767912 PMCID: PMC6465042 DOI: 10.1002/14651858.cd010200.pub2] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Community ambulation refers to the ability of a person to walk in their own community, outside of their home and also indoors in private or public locations. Some people choose to walk for exercise or leisure and may walk with others as an important aspect of social functioning. Community ambulation is therefore an important skill for stroke survivors living in the community whose walking ability has been affected. OBJECTIVES To determine: (1) whether interventions improve community ambulation for stroke survivors, and (2) if any specific intervention method improves community ambulation more than other interventions. SEARCH METHODS We searched the Cochrane Stroke Group Trials Register (September 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (November 2013), PubMed (1946 to November 2013), EMBASE (1980 to November 2013), CINAHL (1982 to November 2013), PsycINFO (1887 to November 2013), Scopus (1960 to November 2013), Web of Science (1900 to November 2013), SPORTDiscus (1975 to November 2013), and PEDro, CIRRIE and REHABDATA (November 2013). We also searched ongoing trials registers (November 2013) and reference lists, and performed a cited reference search. SELECTION CRITERIA Selection criteria included parallel-group randomised controlled trials (RCTs) and cross-over RCTs, studies in which participants are adult (aged 18 years or more) stroke survivors, and interventions that were aimed at improving community ambulation. We defined the primary outcome as participation; secondary outcomes included activity level outcomes related to gait and self-efficacy. DATA COLLECTION AND ANALYSIS One review author independently screened titles. Two review authors screened abstracts and full text articles, with a third review author was available to resolve any disagreements. Two review authors extracted data and assessed risk of bias. All outcomes were continuous. The analysis for the primary outcome used the generic inverse variance methods for meta-analysis, using the standardised mean difference (SMD) and standard error (SE) from the participation outcomes. Analyses for secondary outcomes all used SMD or mean difference (MD). We completed analyses for each outcome with all studies, and by type of community ambulation intervention (community or outdoor ambulation practice, virtual practice, and imagery practice). We considered trials for each outcome to be of low quality due to some trial design considerations, such as who knew what group the participants were in, and the number of people who dropped out of the studies. MAIN RESULTS We included five studies involving 266 participants (136 intervention; 130 control). All participants were adult stroke survivors, living in the community or a care home. Programmes to improve community ambulation consisted of walking practice in a variety of settings and environments in the community, or an indoor activity that mimicked community walking (including virtual reality or mental imagery). Three studies were funded by government agencies, and two had no funding.From two studies of 198 people there was low quality evidence for the effect of intervention on participation compared with control (SMD, 0.08, 95% confidence interval (CI) -0.20 to 0.35 (using inverse variance). The CI for the effect of the intervention on gait speed was wide and does not exclude no difference (MD 0.12, 95% CI -0.01 to 0.24; four studies, 98 participants, low quality evidence). We considered the quality of the evidence to be low for all the remaining outcomes in our review: Community Walk Test (MD -6.35, 95% CI -21.59 to 8.88); Walking Ability Questionnaire (MD 0.53, 95% CI -5.59 to 6.66); Six-Minute Walk Test (MD 39.62 metres, 95% CI -8.26 to 87.51) and self-efficacy (SMD 0.32, 95% CI -0.09 to 0.72). We downgraded the quality of the evidence because of a high risk of bias and imprecision. AUTHORS' CONCLUSIONS There is currently insufficient evidence to establish the effect of community ambulation interventions or to support a change in clinical practice. More research is needed to determine if practicing outdoor or community walking will improve participation and community ambulation skills for stroke survivors living in the community.
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Affiliation(s)
- Ruth E Barclay
- University of ManitobaDepartment of Physical Therapy, College of Rehabilitation ScienceR106‐771 McDermot AvenueWinnipegCanadaR3E 0T6
| | - Ted J Stevenson
- St Boniface General HospitalRehabilitation Services409 TacheWinnipegCanadaR2H 2A6
| | - William Poluha
- University of ManitobaSciences and Technology LibraryWinnipegCanadaR3T 2N2
| | - Jacquie Ripat
- University of ManitobaDepartment of Occupational Therapy, College of Rehabilitation ScienceWinnipegCanada
| | - Cristabel Nett
- University of ManitobaDepartment of Physical Therapy, College of Rehabilitation ScienceR106‐771 McDermot AvenueWinnipegCanadaR3E 0T6
| | - Cynthia S Srikesavan
- University of ManitobaApplied Health Sciences PhD Program, School of Medical RehabilitationR106‐771McDermot AvenueWinnipegCanadaR3E 0T6
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An approach to improve the performance of subject-independent BCIs-based on motor imagery allocating subjects by gender. Biomed Eng Online 2014; 13:158. [PMID: 25476924 PMCID: PMC4286930 DOI: 10.1186/1475-925x-13-158] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 11/22/2014] [Indexed: 12/02/2022] Open
Abstract
Background One of the difficulties for the implementation of Brain-Computer Interface (BCI) systems for motor impaired patients is the time consumed in the system design process, since patients do not have the adequate physical nor psychological conditions to complete the process. For this reason most of BCIs are designed in a subject-dependent approach using data of healthy subjects. The developing of subject-independent systems is an option to decrease the required training sessions to design a BCI with patient functionality. This paper presents a proof-of-concept study to evaluate subject-independent system based on hand motor imagery taking gender into account. Methods Subject-Independent BCIs are proposed using Common Spatial Patterns and log variance features of two groups of healthy subjects; one of the groups was composed by people of male gender and the other one by people of female gender. The performance of the developed gender-specific BCI designs was evaluated with respect to a subject-independent BCI designed without taking gender into account, and afterwards its performance was evaluated with data of two healthy subjects that were not included in the initial sample. As an additional test to probe the potential use for subcortical stroke patients we applied the methodology to two patients with right hand weakness. T-test was employed to determine the significance of the difference between traditional approach and the proposed gender-specific approach. Results For most of the tested conditions, the gender-specific BCIs have a statistically significant better performance than those that did not take gender into account. It was also observed that with a BCI designed with log-variance features in the alpha and beta band of healthy subjects’ data, it was possible to classify hand motor imagery of subcortical stroke patients above the practical level of chance. Conclusions A larger subjects’ sample test may be necessary to improve the performances of the gender-specific BCIs and to further test this methodology on different patients. The reduction of complexity in the implementation of BCI systems could bring these systems closer to applications such as controlling devices for the motor rehabilitation of stroke patients, and therefore, contribute to a more effective neurological rehabilitation.
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Kim O, Kim JH. Falls and Use of Assistive Devices in Stroke Patients with Hemiparesis: Association with Balance Ability and Fall Efficacy. Rehabil Nurs 2014; 40:267-74. [PMID: 25042606 DOI: 10.1002/rnj.173] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2014] [Indexed: 02/01/2023]
Abstract
PURPOSE This study investigates balance ability and the fall efficacy with regard to the experiences of stroke patients with hemiparesis. METHODS The experience of falling, the use of assistive devices, and each disease-related characteristic were assessed using face-to-face interviews and a self-reported questionnaire. The Berg Balance Scale and Fall Efficacy Scale were used to measure balance ability and confidence. RESULTS The fall efficacy was significantly lower in participants who had experienced falls than those who had not. The participants who used assistive devices exhibited low balance ability and fall efficacy compared to those who did not use assistive devices. CONCLUSIONS Stroke patients with fall experience and walking aids might be considered at increased risk of falling. CLINICAL RELEVANCE Preventive measures for individuals using walking aids may be beneficial in reducing the fall rate of community-dwelling stroke patients.
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Affiliation(s)
- Oksoo Kim
- Division of Nursing, College of Health Sciences, Ewha Womans University, Seoul, Korea
| | - Jung-Hee Kim
- Department of Nursing, College of Health Sciences, Dankook University, Cheonan, Korea
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