Mental practice and mirror therapy associated with conventional physical therapy training on the hemiparetic upper limb in poststroke rehabilitation: a preliminary study.

BACKGROUND: The presence of sensory and motor deficits is common in patients post stroke. Mental practice (MP) and mirror therapy (MT) can be used as therapeutic techniques for poststroke rehabilitation. Important results have been demonstrated, although they have not established the patients' functional gain or related results of muscle electromyographic (EMG) data to functionality. OBJECTIVE: The aim was to investigate EMG activity and sensory, motor, and functional performance in hemiparetic limbs of patients with stroke after intervention with MP and MT associated with conventional physical therapy training (CPTT). METHODS: Seven patients were treated twice weekly during 8 weeks with MP and MT associated with CPTT of the affected upper limb. The Fugl-Meyer scale and the Barthel Index (BI) were applied to assess sensorimotor ability and independence of patients. Activation of the upper trapezius, biceps brachii, triceps brachii, flexor carpi ulnaris, and extensor carpi radialis was evaluated by means of EMG symmetry index and muscle co-activation measurements. RESULTS: There were statistically significant differences between pre- and postassessment findings for the motor, sensory, and mobility domains of the Fugl-Meyer scale, as well as for BI evaluation. No statistically significant differences were observed when the pre- and posttest symmetry and co-activation data were compared, although there were qualitative changes. CONCLUSIONS: The protocol was effective for improving motor, sensory, and mobility aspects, as well as function involved in activities of daily living. Qualitative changes in symmetry and muscle co-contraction were found, indicating a possible improvement in upper limb rehabilitation of patients with stroke.

Effects of Bolero basic steps on balance and functional mobility in post-stroke hemiparesis: A pilot study.

BACKGROUND: Problems with balance are common after a stroke, and dancing can be a beneficial adjunctive approach to rehabilitation. Dancing can be seen as a strategy to increase motivation, as it may be able to improve motor patterns of stroke patients. In this sense, Bolero is a Cuban rhythm that includes slight movements and provides stimuli to engage one physically and make one learn new motor patterns. This study aimed to investigate the contribution of Bolero basic steps and stretching to the balance of stroke patients. METHODOLOGY: The study included a sample of 11 individuals diagnosed with stroke, who were assessed before and after training Bolero steps and stretching. Participants were assessed using the Berg Balance Scale (BBS), Timed Up and Go (TUG), and Functional Reaching Test (FRT). The sessions took place twice a week for 6 weeks with an average duration of 50 min per session. Stretching exercises were sustained for 30 s each. After stretching, Bolero steps were taught with gradually increasing difficulty levels. Stretches were repeated at the end of the session. RESULTS: Paired sample t-tests showed significant difference in all instruments pre-versus post-therapy (p < 0,05). DISCUSSION: Based on the results, the performance of Bolero steps was feasible for these individuals, the duration and intensity of the classes were well tolerated and there was a significant improvement in balance. These findings corroborate studies carried out with other types of dance, such as Tango, Jazz and Merengue, with post-stroke patients. CONCLUSION: Training the basic steps of Bolero and stretching significantly improved balance in this sample of stroke patients.

Immediate effect of mental practice with and without mirror therapy on muscle activation in hemiparetic stroke patients.

Mental practice (MP) consists of the repeated mental rehearsal of a physical skill without movement, called motor imagery (MI). Studies show that MP and MI associated mirror therapy (MPMT) may improve muscle control of the upper limbs in hemiparesis. This study aimed to evaluate muscle activation during active flexion of the wrist (MA), MP, and MPMT in patients with history of stroke and hemiparesis. Individuals diagnosed with stroke showing sequelae of upper limb hemiparesis were enrolled. The flexor carpi ulnaris was analyzed using electromyography during tasks (MA, MP, MPMT) involving wrist flexion. Greater electromyographic activity was detected during MP and MPMT techniques compared to active movement (p = 0.02). There was no significant difference between MP and MPMT (p = 0.56). These results were found in both the affected limb and unaffected limb. Immediate effects on muscle activation are experienced during MP and MPMT, and muscle activity was similar with both therapies.