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Objective: To investigate the efficacy of motor imagery therapy (MIT) based on functional near-infrared spectroscopy (fNIRs) technology in rehabilitation of upper limb function after cerebral infarction, so as to provide guidance for clinical practice. Methods: A total of 84 patients with upper limb dysfunction after acute cerebral infarction admitted to Wuhan Puren Hospital from January 2020 to January 2021 were included in this study and randomly divided into two groups based on random number table method: experimental group and control group, with 42 cases in each group. Both groups were given active symptomatic treatment. The control group received conventional exercise rehabilitation, while the experimental group also received MIT based on fNIRs technology in addition to the treatment method adopted by the control group, lasting for eight weeks. The simplified Fugl-Meyer scale was utilized to evaluate the recovery of upper limb function, and the changes of Oxy-Hb and Deoxy-Hb concentrations in the frontal area of brain tissue were measured to evaluate the total effective rate of clinical rehabilitation. Results: At four and eight weeks of treatment, the Fugl-Meyer scores of the two groups were significantly higher than those before treatment (P<0.05), and those in experimental group were significantly higher than those in control group (P<0.05), with no significant difference before treatment (P>0.05). After treatment, Oxy-Hb concentration in the experimental group was higher than that in the control group (P<0.05), while Deoxy-Hb concentration was lower than that in the control group, with a statistical significance (P<0.05). The total effective rate of rehabilitation in the experimental group was 88.10%, which was significantly higher than 73.81% in the control group (P<0.05). Conclusion: Motor imagery therapy (MIT) Based on fNIRs technology has important clinical value in rehabilitation of upper limb function after cerebral infarction and is superior to conventional exercise rehabilitation alone, boasting a variety of effects, such as improving the curative effect, ameliorating blood oxygen in brain tissue, and promoting the rehabilitation of upper limb function of patients.
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Background: Motor imagery therapy (MIT) showed positive effects on upper limbs motor function. However, the mechanism by which MIT improves upper limb motor function is not fully understood. Therefore, our purpose was to investigate the changes in functional connectivity (FC) within and outside the sensorimotor network (SMN) induced by MIT associated with improvement in upper limb motor function in stroke patients. Methods: A total of 26 hemiplegic stroke patients were randomly divided into MIT (n = 13) and control (n = 13) groups. Fugl-Meyer Assessment Upper Extremity Scale (FMA-UL), Modified Barthel Index (MBI) and resting-state functional magnetic resonance imaging (rs-fMRI) were evaluated in the two groups before treatment and 4 weeks after treatment. The efficacy of MIT on motor function improvement in stroke patients with hemiplegia was evaluated by comparing the FMA-UL and MBI scores before and after treatment in the two groups. Furthermore, the FC within the SMN and between the SMN and the whole brain was measured and compared before and after different treatment methods in stroke patients. The correlation analysis between the improvement of upper limbs motor function and changes in FC within the SMN and between the SMN and the whole brain was examined. Results: The FCs between ipsilesional primary motor cortex (M1.I) and contralateral supplementary motor area (SMA.C), M1.I and ipsilesional SMA (SMA.I), and SMA.C and contralateral dorsolateral premotor cortex (DLPM.C) significantly increased in the control group but decreased in the MIT group; while the FC between SMA.C and contralateral primary somatosensory cortex (S1.C) significantly increased in the control group but showed no significant difference in the MIT group. The FCs between M1.I and the ipsilesional hippocampal gyrus and ipsilesional middle frontal gyrus significantly decreased in the control group but increased in the MIT group; while the FC in the contralateral anterior cingulate cortex significantly increased in the MIT group but there was no significant difference in the control group. The results of the correlation analysis showed that the differences in abnormal intra-FCs within the SMN negatively correlated with the differences in FMA and MBI, and the difference in abnormal inter-FCs of the SMN positively correlated with the differences in FMA and MBI. Conclusions: MIT can improve upper limb motor function and daily activities of stroke patients, and the improvement effect of conventional rehabilitation therapy (CRT) combined with MIT is significantly higher than that of CRT alone. CRT may improve the upper limb motor function of stroke patients with hemiplegia mainly through the functional reorganization between SMN, while MIT may mainly increase the interaction between SMN and other brain networks.
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BACKGROUND: Rehabilitation nursing is considered an indispensable part of the cerebral infarction treatment system. The hospital-community-family trinity rehabilitation nursing model can provide continuous nursing services across hospitals, communities, and families for patients. AIM: To explore the application of a hospital-community-family rehabilitation nursing model combined with motor imagery therapy in patients with cerebral infarction. METHODS: From January 2021 to December 2021, 88 patients with cerebral infarction were divided into a study (n = 44) and a control (n = 44) group using a simple random number table. The control group received routine nursing and motor imagery therapy. The study group was given hospital-community-family trinity rehabilitation nursing based on the control group. Motor function (FMA), balance ability (BBS), activities of daily living (BI), quality of life (SS-QOL), activation status of the contralateral primary sensorimotor cortical area to the affected side, and nursing satisfaction were evaluated before and after intervention in both groups. RESULTS: Before intervention, FMA and BBS were similar (P > 0.05). After 6 months' intervention, FMA and BBS were significantly higher in the study than in the control group (both P < 0.05). Before intervention, BI and SS-QOL scores were not different between the study and control group (P > 0.05). However, after 6 months' intervention, BI and SS-QOL were higher in the study than in the control group (P < 0.05). Before intervention, activation frequency and volume were similar between the study and the control group (P > 0.05). After 6 months' intervention, the activation frequency and volume were higher in the study than in the control group (P < 0.05). The reliability, empathy, reactivity, assurance, and tangibles scores for quality of nursing service were higher in the study than in the control group (P < 0.05). CONCLUSION: Combining a hospital-community-family trinity rehabilitation nursing model and motor imagery therapy enhances the motor function and balance ability of patients with cerebral infarction, improving their quality of life.
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ObjectiveTo observe the effect of motor imagery therapy on hand function and motor imagery ability of stroke patients. MethodsFrom March, 2018 to March, 2020, 41 stroke patients in Beijing Bo'ai Hospital were selected and randomly divided into control group (n = 20) and observation group (n = 21). Both groups received conventional rehabilitation training, and the observation group received motor imagery therapy in addition, for four weeks. Before and after training, the scores of Fugl-Meyer Assessment-Hand (FMA-H) and Kinesthetic and Visual Imagery Questionnaire-10 (KVIQ-10), and the accuracy of mental rotation task were compared between two groups. ResultsOne patient in the observation group dropped down. Before training, there was no significant difference in the scores of FMA-H and KVIQ, and the accuracy of mental rotation task between two groups (P > 0.05). After training, all the indexes improved in both groups (t > 6.611, P < 0.001), and the scores of FMA-H (t = 3.742, P < 0.001) and KVIQ (t = 4.122, P < 0.001), and the accuracy of mental rotation task (t = 2.075, P < 0.05) were higher in the observation group than in the control group. ConclusionMotor imagery therapy could facilliate the recovery of hand dysfunction and improve the motor imagery ability of stroke patients.
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Objective:To explore the effect of combining motor imagery therapy (MIT) with kinesio taping in rehabilitating the upper limb motor function of stroke survivors.Methods:Ninety-two stroke survivors were randomized into a control group ( n=31), an MIT group ( n=31), and a combination group ( n=30). All were given 40 minutes of basic rehabilitation therapy daily, while the MIT group received additional MIT therapy, and the combination group received kinesio taping with the MIT therapy. The taping was applied according to a patient′s condition and changed every other day. The MIT was conducted twice a day. The experiment lasted 8 weeks, six days a week. Before and after the 8 weeks, the upper limb functioning, ability in the activities of daily living and muscle tension of each subject were assessed using the Fugl-Meyer assessment for the upper extremities (FMA-UE), the Hong Kong version of the functional test for a hemiplegic upper extremity (FTHUE-HK), the modified Barthel index (MBI) and the modified Ashworth scale (MAS). Results:The average post-treatment FMA-UE and MBI scores of the combination group were significantly higher than those of the MIT group, and both were significantly higher than the control group′s averages. The average FTHUE-HK grading of the combination group and MIT group after the treatment was significantly higher than in the control group, with that of the combination group significantly superior to the MIT group′s average. After the intervention the average MAS rating of the combination group was significantly lower than that of the control group.Conclusion:MIT combined with Kinesio taping can significantly improve the upper limb motor functioning of stroke survivors, and significantly reduce their abnormal muscle tone compared to traditional treatments.
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Objective:To observe any effect of combining motor imagery therapy (MIT) with repeated transcranial magnetic stimulation (rTMS) for improving upper limb motor functioning after a stroke.Methods:Ninety stroke survivors were randomly divided into a control group, an MIT group and a combination group, each of 30. All received conventional rehabilitation therapy, while the MIT group additionally received MIT and the combination group received the MIT along with 1Hz rTMS applied over the M1 region of the contralateral cortex. Before and after 4 weeks of treatment, everyone′s upper limb functioning was quantified using the Fugl-Meyer assessment scale (FMA) and the Hong Kong version of the hemiplegia upper limb function test (FTHUE-HK). Motor evoked potentials (MEPs), cortical latency (CL) and central motor conduction time (CMCT) were also recorded.Results:After the treatment the average FMA and FTHUE-HK scores of all three groups had improved significantly. The average CL and CMCT were significantly shortened. Compared with the control group, the average upper limb FMA score and FTHUE-HK scores of the treatment group were significantly higher. The combination group showed a significant improvement in its average MEP cortical latency and CMCT values.Conclusions:MIT therapy alone can improve the upper limb motor functioning of stroke survivors, but it is more effective in combination with rTMS.
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Objective To investigate the effect of the mirror therapy (MT) combined with motor imagery therapy (MIT) on the lower limb motor performance,balance and ability in the activities of daily living of ischemic stroke patients soon after a stroke.Methods Forty hospitalized ischemic stroke patients were randomly allocated to an MT+MIT group (n=20) or an MIT only group (n=20).In addition to routine rehabilitation,the MIT group exercised practicing knee extension and ankle dorsiflexion 30 minutes a day,five days a week for 8 weeks following motor imagery therapy protocols,while the MT+MIT group accepted MIT combined with mirror therapy.The Fugl-Meyer lower extremity assessment (FMALE),Berg Balance scores (BBSs) and the Modified Barthel index (MBI) were used to evaluate the effects of the treatment before the treatment and after 4 and 8 weeks of therapy.Results Before the intervention there was no significant difference between the two groups in terms of their average FMA,BBS and MBI ratings.After 4 weeks of treatment a significant improvement was observed in the MT+MIT group's average FMA-LE and BBS scores and in the flat walking component of the MBI.In the MIT group only the average bed/wheelchair transfer and flat walking scores in the MBI were significantly improved.After 8 weeks the MT+MIT group's average FMA-LE and BBS scores had improved significantly,along with its average scores in the feeding,dressing,grooming,bathing,urination,bed/wheelchair transfer,walking up and down stairs and flat walking components of the MBI.In the MIT group the average FMA-LE and BBS scores had improved significantly,along with those for bed/wheelchair transfer,walking up and down stairs and flat walking in the MBI.After both 4 and 8 weeks,the MT+MIT group's average scores were consistently significantly better than those of the MT group.Conclusion Mirror therapy can significantly enhance the effectiveness of motor imagery therapy when they are combined in the rehabilitation of ischemic stroke patients in the early post-stroke stage.
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Objective To explore the effect of motor imagery therapy combined with balance evaluation and training on balance and performance in the activities of daily living (ADL) after an initial stroke.Methods A total of 48 stroke patients were randomly divided into a control group (n =25) and an observation group (n =23).All of the patients in both groups were given routine rehabilitation and balance training.In addition,the patients of the observation group were given motor imagery therapy.Balance and ADL performance were assessed before the training and 2 weeks and 4 weeks after the training began.The subjects' balance was analyzed using the center of the gravity shift index,shift angle,total length of shift trace and envelope area using a balance evaluation system and the balance subscale of the Fugl-Meyer assessment (FM-B).Performance in the activities of daily living was assessed using the modified Barthel index (MBI).Results Before the training there were no significant differences between the two groups in terms of any of the measurements.After 2 weeks and 4 weeks of training,all the measurements in both groups were significantly better than those before training,but the improvement of the observation group was significandy greater than that of the control group (except in terms of the MBI).Conclusion Motor imagery therapy combined with balance training can distinctly improve the balance and activities of daily living of stroke survivors.The combination is worthy of application in the clinic.
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Objective To investigate the effect of transcranial direct current stimulation (tDCS) combined with motor imagery therapy on the function of upper limbs of stroke survivors.Methods Ninety-four stroke patients were randomized into a routine group (n=31),a motor imagery group (n=31),and a combination group (n =32).All the patients received basic routine rehabilitation therapy,while the routine group accepted traditional occupational therapy,the motor imagery group accepted motor imagery therapy,and the combination group accepted tDCS and motor imagery therapy.The upper limb function of the patients was assessed using Fugl-Meyer assessment (FMA) of upper extremities,the Hong Kong version of functional test for the hemiplegic upper extremity (FTHUE) and the modified Barthel Index (MBI) before and after 8-week treatment.Results The average FMA of the combination group and motor imagery group were (37.81 ± 12.80) and (31.39± 15.62),respectively,both significantly higher than that of the routine group (27.61± 14.90).The average FTHUE of the combination group and motor imagery group was both significantly higher than that of the routine group.Moreover,the average MBI of the combination group and motor imagery group were (57.78±7.73) and (51.87±9.31),respectively,both significantly higher than that of the routine group (45.19:t:9.07) (P＜0.05 for all).Conclusion tDCS combined with motor imagery therapy can significantly improve the upper limb function of stroke patients,significantly superior to tDCS or motor imagery therapy solely.
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Objective To investigate the effect of motor imagery therapy based on mirror neuron theory on the motor function and gait in stroke survivors.Methods Forty-nine stroke survivors were randomly divided into a treatment group (n =24) and a control group (n =25) using a random number table.All the patients in both groups were given similar conventional rehabilitation treatment.In addition,the patients in the treatment group were given motor imagery training based on mirror neuron theory once a day for 20 min each time,5 days a week,lasting 8 weeks.The Fugl-Meyer assessment (FMA),Functional Ambulation Categories (FACs),average step length,the percentage of time spent on the intact foot and the paralyzed foot,and 6 minute walking distance were used to evaluate the subjects' motor function and gait before and after 8 weeks of treatment.Results Before the intervention there was no significant difference between the two groups in terms of any of the measurements.At the end of the 8 weeks of treatment all measurements in both groups had significantly improved compared with before training.The averages of all the measures were significantly better in the treatment group than in the control group.Conclusions Motor imagery training based on mirror neuron theory can improve the motor function and gait of stroke survivors.
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Objective To study the effect of motor imagery therapy combined with conventional rehabilitation treatment on walking ability in patients with post-stroke hemiplegia.Methods Eighty patients with post-stroke hemiplegia were randomly divided into a treatment group (40 cases) and a control group (40 cases).All the patients in both groups were given basic medication and conventional rehabilitation treatment.In addition,the patients in treatment group were given motor imagery therapy.The 10 m maximum walking speed (10 m MWS),stride length,cadence,Fugl-Meyer motor assessment (lower limb) (FMA-L) and Holden's functional ambulation classification (FAC) were used to evaluate walking ability before the beginning of training and at the end of six weeks of training.Results Before intervention there was no significant difference between the two groups in terms of all the assessment (P ＞0.05).At the end of training,all measurements in both groups [the treatment group:10 m MWS (0.53 ± 0.20)m/s,stride length (78.91 ± 20.46) cm,cadence (78.10 ± 12.03) min,FMA-L (24.13 ±5.77),FAC (3.60±1.01);the control group:10 m M WS (0.42 ±0.15)m/s,stride length (69.75 ± 18.31)cm,cadence (71.14±9.29)/min,FMA-L (20.65 ±4.70),FAC (2.93 ±0.89)] were significantly better than those before training (P ＜ 0.05),and the improvements in treatment group were significantly better than those in control group (P ＜ 0.05).Conclusion Motor imagery therapy combined with conventional rehabilitation treatment can distinctly improve the walking ability in patients with post-stroke hemiplegia.
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@# Objective To observe the effect of motor imagery therapy on patients accepted radiotherapy after operation for cerebral glioma. Methods 34 patients were randomly divided into control group (n=17) and observation group (n=17). Both groups accepted routine physiotherapy during radiotherapy, 45~60 min/d, 5 times a week for 4 weeks, while the observation group underwent motor imagery additionally, 15 min/d for 4 weeks. They were evaluated with Fugl-Meyer Assessment (FMA), Manual Muscle Test (MMT) and modified Barthel Index (MBI) before and after treatment., and with Karnofsky Performance Scale (KPS) 1 year later. Results There was no significantly difference in the scores of FMA, MMT and MBI between 2 groups before treatment (P>0.05). There was no significantly difference in the score of FMA in both groups before and after treatment (P>0.05). The score of MMT improved in the observation group after treatment (P<0.01). The scores of MBI improved in both groups after treatment (P<0.05). And there was no significantly difference in the D-value score of FMA, MMT and MBI between 2 groups (P>0.05). After 1 year follow-up, KPS showed that the number of survival patients and their quality of life were better in the observation group than in the control group (P<0.05). Conclusion Motor imagery therapy can improve the muscle force, activities of daily living and long-term quality of life in patients during radiotherapy after neurosurgery for cerebral glioma.
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Objective To investigate the effect of motor imagery therapy supplemented with scalp acupuncture for improving the lower limb motor function of stroke patients with hemiplegia.Methods A total of 120 hemiplegic stroke patients were randomly divided into an experimental group and a control group with 60 patients in each.All were given routine medical care and scalp acupuncture (stimulating the posterior and anterior oblique line of the parietal-temporal lobe contralateral to the hemiplegic limb).The treatment was given daily for 3 weeks as one session,and 2 sessions were administered to both groups.The experimental group was given motor imagery therapy in addition.Each treatment took about 25 min every day for 3 weeks as one session,and again 2 consecutive sessions were administered.The temporal and spatial gait parameters (10m maximum walking speed,stride length and cadence) of all of the patients were assessed,the Fugl-Meyer lower extremity assessment (FMA-L) was conducted and functional ambulation classifications (FACs) were assigned before therapy and at the end of the 6 weeks.Results After 6 weeks of treatment,all of the measures had improved significantly for both groups.The experimental group,however,had improved significantly more than the control group.Conclusion Motor imagery therapy can supplement scalp acupuncture to improve lower limb motor function in hemiplegic stroke patients.
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Objective To study the effect of motor imagery therapy combined with conventional physical training on hemiplegia lower extremity function in stroke patients with hemiplegia.Methods Thirty hemiplegic patients meeting the eligible criterions were randomly divided into two groups: a treatment group (n = 13 ) and a control group ( n = 17).All subjects accepted conventional rehabilitative treatment.Patients in treatment group were treated with motor imagery therapy after physical training, while the patients in control group were treated with physical training only.Motor function was measured by the percentages of changes in maximum loading on affected lower limb (PL%), Barthel index (BI), 5m maximum back and forth walking speed (5m MBFWS), Berg balance scale ( BBS), Fugl-Meyer motor assessment ( lower limb) (FMA-L) before the beginning of training and at the end of sixweek training.Results In both groups, all measurements at the end of training improved significantly ( P < 0.01 )compared to that at the beginning of training.After the whole training course, PL% and 5m MBFWS (m/s) in treatment group were significantly better compared to those in control group( P < 0.05 ), and the other measurements were not statistically significant between two groups( P > 0.05 ).Conclusion Motor imagery therapy had positive effect on hemiplegia lower extremity function of sub-acute stroke patients.
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@# Motor imagery therapy is based on the theory of plasticity in the central nervous system. Movement with imagery improved reconstruction of damaged motor conduction pathway, and made restoration of central nervous system. Motor imagery adapts to recovery mode of stroke, and was proved to be effective on motor function when applied with physical therapy for stroke patients. This article would review its background, mechanisms, Methods and effects, etc.
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@#ObjectiveTo observe the effect of constraint-induced movement therapy (CIMT) combined with motor imagery therapy (MIT) on the upper extremity function of stroke patients with hemiplegia.Methods120 hemiplegic patients caused by brain injury were randomly divided into the control group, CIMT group, MIT group and combined therapy group with 30 cases in each group. The every group was treated with commensurate rehabilitation management respectively, 4 weeks as one course of treatment. All patients were assessed with the Simple Test for Evaluating Hand Function (STEF), the upper limb movement Fugl-Meyer Assessment (FMA), and Modified Barthel Index (MBI) before and after the treatment.ResultsBefore the treatment, there was no significant difference in STEF, scores of upper limb movement FMA and MBI among the four groups ( P>0.05). After the treatment, the STEF, scores of upper limb movement FMA and MBI of the CIMT group and MIT group improved ( P<0.05), that of the combined therapy group were superior to any other group ( P<0.01).ConclusionCIMT and MIT can promote the recovery of upper extremity function of hemiplegic patient, but the better therapeutic effect will be obtained when these two therapies combined.