Can mental practice adjunct in the recovery of motor function in the upper limbs after stroke? A systematic review and meta-analysis.

BACKGROUND: Studies indicate that mental practice can be an adjuvant rehabilitation, improving motor functions. AIM: To synthesize the evidence on the intervention with the mental practice for the rehabilitation of the upper limb after stroke in the context of a dependent task. METHODS: The review was registered on the PROSPERO with protocol number: CRD42020166624. We searched the PubMed, Medline, Embase, Central, PEDro, and Web of Science from randomized clinical trials from 1975 to 2022. A literature review was conducted with 13 studies that synthesized findings on mental practice such as adjuvant rehabilitation in the recovery of the upper limb after stroke based on Fugl-Meyer Assessment (FMA) Motor and action research arm test (ARAT) scores. RESULTS: The sample size was 232 were part of the intervention group and 180 of the control group. The findings no showed results in favor of mental practice after stroke accordingly to ARAT and FMA Motor scores (P > 0.05). CONCLUSION: Current evidence does not support the use of the mental practice to increase the recovery of the upper limb after stroke, although the evidence is conflicting for some aspects of the technique.

Effects of aquatic physiotherapy versus conventional physical therapy on the risk of fall in the elderly: a randomized clinical tria / Efeitos da fisioterapia aquática versus fisioterapia convencional no risco de queda em idosos: ensaio clínico

Objective: To identify whether physiotherapy treatment in water is more effective than the treatment in land environment, aiming at improving the process of physical limitation or functional inability (gait speed, balance, motor abilities) caused by lack of balance in elderly with risk of fall. Methods: Randomized clinical trial, experimental study. The sample was composed of 35 senior individuals of both sexes, with average age of 65. Nineteen people composed the control Group /Conventional Physiotherapy, while the rest composed the experimental Group/Aquatic Physical therapy. Both groups were submitted to twenty sessions of physical therapy, twice a week, for 50 minutes in individual treatment. Aerobic activities were conducted for both groups separately. Exercises using water specific therapy, such as Halliwick rotation control and Bad Ragaz ring method, were used in the aquatic group and in the conventional group, physiotherapeutic techniques were applied, approaching the concepts of proprioceptive neuromuscular facilitation (PNF) and decubitus change training. The following tests were used to measure the risk of fall/balance: Timed Up and Go Test, Sit-to-Stand in 30 seconds and Functional Reach. Results: Both physiotherapeutic interventions, aquatic and conventional, showed to be greatly efficient however aquatic physiotherapy showed certain advantages compared to conventional physical therapy, promoting more beneficial effects in the gait speed, balance, motor abilities and, mainly, in the reduction of the risk of fall. (AU)

Objetivo: Identificar se a Fisioterapia aquática é mais eficaz que a fisioterapia convencional, visando a melhora do processo de limitação física ou incapacidade funcional (Velocidade da marcha, equilíbrio, habilidades motoras) causada por desequilíbrio em pacientes idosos com risco de queda. Métodos: Ensaio clínico randomizado, estudo experimental. A amostra foi composta por 35 idosos de ambos os sexos, com uma média de idade de 65 anos. Dezenove pessoas compuseram o Grupo Controle/Fisioterapia Convencional, enquanto o restante constituiu o Grupo Experimental / Fisioterapia Aquática. Ambos os grupos foram submetidos a vinte sessões de fisioterapia, duas vezes por semana, durante 50 minutos em tratamento individual. As atividades aeróbicas foram realizadas para ambos os grupos separadamente. Exercícios utilizando terapia específica da água, como o controle de rotação de Halliwick e o método do anel de Bad Ragaz, foram utilizados no grupo aquático e, no grupo convencional, foram aplicadas técnicas fisioterapêuticas, abordando os conceitos de facilitação proprioceptiva e treinamento de mudança de decúbito. Os seguintes testes foram usados para medir o risco de queda/equilíbrio: Timed Up and Go Teste, Teste de sentar e levantar em 30 segundos e Teste de Alcance Funcional. Resultados: Ambas as intervenções fisioterapêuticas, aquáticas e convencionais se mostraram bastante eficientes, entretanto a fisioterapia aquática apresentou certas vantagens em relação à fisioterapia convencional, promovendo efeitos mais benéficos na velocidade da marcha, equilíbrio, habilidades motoras e, principalmente, na redução do risco de queda. (AU)

Changes in the theta band coherence during motor task after hand immobilization.

Many different factors can temporarily or permanently impair movement and impairs cortical organization, e.g. hand immobilization. Such changes have been widely studied using electroencephalography. Within this context, we have investigated the immobilization effects through the theta band coherence analysis, in order to find out whether the immobilization period causes any changes in the inter and intra-hemispheric coherence within the cerebral cortex, as well as to observe whether the theta band provides any information about the neural mechanisms involved during the motor act. We analyzed the cortical changes that occurred after 48 hours of hand immobilization. The theta band coherence was study through electroencephalography in 30 healthy subjects, divided into two groups (control and experimental). Within both groups, the subjects executed a task involving flexion and extension of the index finger, before and after 48 hours. The experimental group, however, was actually submitted to hand immobilization. We were able to observe an increase in the coupling within the experimental group in the frontal, parietal and temporal regions, and a decrease in the motor area. In order to execute manual tasks after some time of movement restriction, greater coherence is present in areas related to attention, movement preparation and sensorimotor integration processes. These results may contribute to a detailed assessment of involved neurophysiological mechanism in motor act execution.