ABSTRACT
Stroke is a disease with a high disability rate， and often leads to limb dysfunction， especially upper limb motor dysfunction， which significantly affects the patients’ abilities and quality of life. With patients' increasing demand for functional recovery， various therapeutic techniques of rehabilitation medicine have been rapidly developed. As an important active central intervention technology， motor imagery training can be initiated by the patient's brain and activate the sensorimotor network to accelerate the repair of limb functions. The development of preventive medicine has promoted the continuous evolution of the concept of rehabilitation. The strategies of full cycle functional protection and disability prevention have been improved and developed in the clinical and scientific research practice of upper limb rehabilitation after stroke. The motor imagery training can activate the upper limb motor neural network in the early stage of stroke to prevent functional loss； In the recovery period， it can accelerate the neural function remodeling and reduce the upper limb disability； In the later stage after stroke， it can improve the performance of upper limb function in daily life， thus helping patients return to family life and society. This article reviews the research progress in recent years in China and abroad in the application of motor imagery training for the full cycle function protection and disability prevention of stroke.
ABSTRACT
Objective:To evaluate the effect of motor imagery training on motor and executive function in the older population. Methods:Articles about the impact of motor imagery training on the motor and cognitive functions of the elderly in the databases of Web of Sciences, PubMed, CNKI, Wanfang data and VIP were searched from 1980 to 2020. The training program, rehabilitation effect and relatec factors of motor image training in the elderly were analyzed and summarized. Results:Twelve articles were included finally. The motor image training that suited the elderly over 60 years old was usually combined with actual exercise training, mostly for four to twelve weeks, two to three times a week and 15 to 60 minutes a time. Motor imagery training was effective on standing balance, postural control, falls and muscle strength, to improve the ability to solve conflict problems, working memory and cognitive flexibility. Conclusion:Motor imagery training is an effective way to delay the decline of physical function and improve the executive function of the elderly. It is needed to construct a reasonable and standard motor imagery training program according to the characteristics of the elderly, to improve the effect.
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Objective:To observe and analyze the clinical effect of combining motor imagery training (MIT) with transcranial direct current stimulation (tDCS) for improving the upper limb functioning of hemiplegic stroke survivors.Methods:Ninety stroke survivors with hemiplegia were randomly divided into a conventional group (treated with tDCS) and a combination group (treated with MIT combined with tDCS), each of 45. The conventional group received 20min of tDCS using the IS200 intelligent electrical stimulator once daily, 6 times/week, for 4 weeks. The combination group received 40min of motor imagery training right after the tDCS treatment. Before and after the treatment, upper limb motor functioning was evaluated using the Fugl-Meyer assessment for the upper extremities (FMA-UE) and the Hong Kong version of a functional test for the hemiplegic upper extremity (FTHUE-HK). Surface electromyographs were recorded from the anterior deltoid and the triceps brachii muscles during maximum active shoulder flexion and elbow extension. The muscle strength of the affected limb was evaluated using the root mean square values of the integrated electromyograms (IEMGs).Results:There were no significant differences between the groups before the treatment. Afterward, significant improvement was observed in the average FMA-UE scores, FTHUE-HK scores, surface EMG indexes and iEMG values in both groups. The improvement in the combination group was significantly greater than in the conventional group.Conclusion:Combining MIT with tDCS can better improve upper limb motor functioning and muscle strength after a stroke survivors than tDCS alone.
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Objective To measure the efficacy of combining motor imagery training ( MIT) with convention-al therapy in improving stroke patients′upper-extremity function. And to seek a cortical reorganization mechanism as-sociated with the improvement using resting-state functional magnetic resonance imaging ( rs-fMRI) . Methods Ten stroke survivors were selected as an experimental group. They were given motor imagery training for four weeks ( 30 minutes a day, 5 days a week) and conventional rehabilitation therapy ( 40 minutes a day, 5 days a week) . Another 10 healthy counterparts were the control group. Before and after the four weeks of treatment, both groups were as-sessed using the upper extremity Fugl-Meyer assessment ( FMA-UE) and the modified Barthel index ( MBI) . Moreo-ver, rs-fMRI was conducted to assess functional connectivity between cortical regions and the ipsilesional primary mo-tor cortex ( M1) before and after the intervention. The laterality index ( LI) of the primary motor or sensory cortex was also calculated. Results After the intervention, the average FMA-UE and MBI scores of the experimental group had increased significantly. After MIT and conventional therapy there was increased functional connectivity between the ip-silesional and contralesional M1 areas, and between the ipsilesional M1 and contralesional primary sensory cortex ( S1) and frontal lobe, the functional connection between the ipsilesional M1 and the ipsilesional paracentral lobule and the anterior cingutate was also increased. More specifically, the LI relating M1 and S1 decreased after the inter-vention, tending toward the normal level. LIMI decreased significantly. Conclusion The 4-week regimen of motor imagery training and conventional therapy resulted in functional improvement in the upper limbs and greater ability in the activities of daily living. The observed improvements may be due to cortical reorganization, including better func-tional connectivity between the bilateral M1 areas and increased connectivity between the ipsilesional M1 area and some non-motor areas. There is some recovery of symmetry in the bilateral primary motor cortex.
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Objective To investigate the short-term and long-term effect of motor imagery training on visual imagery and kinesthetic imagery of athletes.Methods Twenty athletes majoring in the sports training of Capital University of Physical Education were selected into the experimental group,while 20 counterparts majoring in the human kinetic science were selected into the control group.All subjects received motor imagery training,and were assessed their visual imagery and kinesthetic imagery at three before the training,as well as ten minutes and 48 hours after the training.Results The repetitive measurement and analysis of variance showed that the visual imagery and kinesthetic imagery scores had the main effect of time factor [FvI (2,37)=7.57,P＜0.01;FK1 (2,37)=ll.75,P＜0.01)],as the scores were the highest at ten minutes after training,the second highest at 48 hours after training and the lowest before training.The visual imaginary scores increased significantly after the training,but had no significant difference 48 hours after the training compared to that before the training.After the training the kinesthetic imagery scores increased significantly and then declined slowly,and there were significant differences in the score before and 48 hours after the training (P=0.009).The experimental group and the control group had the same change trend in the visual and kinesthetic imagery scores.The average scores of the former group were higher than the latter at the same time points but without significant differences.The visual and kinesthetic imagery scores had no main effect of group factor,and there was no interaction effect of time factor and group factor.Conclusion Motor imagery training could increase the ability of visual and kinesthetic imagery of people never participating in motor imagery training and the short-term effect was more obvious.The long term effect of motor imagery training was more significant on kinesthetic imagery than visual imagery.