Mental Practice in Post-stroke Subjects

Not Applicable

• Conditions: Stroke Sequelae; Stroke
• Interventions: Other: Physical practice; Other: Mental practice; Other: Videotherapy

• Registration Number: NCT03251209
• Lead Sponsor: Universidade Federal do Rio Grande do Norte

Brief Summary

Among the limitations caused by cerebrovascular accident (CVA), the upper limb (MS) undergoes changes that limit the individual in his ability to maintain an active social life. Mental Practice (MP) consists of the internal reproduction of an event, which is repeated extensively in order to learn or improve an already known skill. The objective of the study is evaluate the effects of the physical practice associated with PM, on paretic MS. Subjects with unilateral stroke over 6 months, age\> 18 years and who were able to hold objects will be selected. Subjects with painful conditions that affected exercise performance,\> 3 spasticity by Ashworth, and cognitive deficit suggested by the Mini Mental State Examination will be excluded.

Detailed Description

There are 3 study protocols. The MP protocol 1 comprise 4 steps: 1) 5 minutes of global relaxation; 2) Video therapy, being 2 minutes / task (4 distinct tasks: stacking cubes, opposition of fingers with precision gripping, passing water from one glass to another, sequencing of bottles); 3) MP: think about the tasks assisted in the video for 5 minutes / task. 4) Physical Practice: reproduce through the motor execution, the activities assisted in the video (5 minutes / task). The MP protocol 2 was the same, changing the order: first physical practice and after MP. For the protocol 3 without PM, step 3 was suppressed, remaining the remaining steps. There were 15 sessions, 2x / week, for 1 hour. The Fugl-Meyer (FM) Scales, Ashworth Modified Scale (EMA), Functional Independence Measurement (MIF), Action Research Arm Test (ARAt), Box and block task (BBT) and Theory of mind battery (ToM) will be applied before and after the sessions, and in 3 months follow-up.

Study Timeline

• Study Start: 2017-04-20
• Primary Completion: 2017-06-10
• Status Verified: 2017-08
• Study First Submitted: 2017-08-07
• Study First Submitted QC: 2017-08-15
• Last Update Submitted: 2017-08-15
• Study First Posted: 2017-08-16
• Last Update Posted: 2017-08-16
• Study Completion: 2017-12-01

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 30

Inclusion Criteria

• Clinical diagnosis of stroke, ischemic or hemorrhagic, for more than 6 months, age above 18 years, unilateral involvement and are able to hold objects

Exclusion Criteria

• Painful conditions that affect the ability to perform the proposed exercises, spasticity greater than 3 by the Ashworth Scale and cognitive deficits that will be evaluated by the Mini Mental State Examination (MMSE)

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Group 2	Physical practice	Post-stroke participants receive the mental practice after the physical practice. The activities will be presented in a videotherapy way.
Group 1	Videotherapy	Post-stroke participants receive the mental practice before the physical practice. The activities will be presented in a videotherapy way.
Group 3	Physical practice	Post-stroke participants receive only physical practice. The activities will be presented in a videotherapy way.
Group 3	Videotherapy	Post-stroke participants receive only physical practice. The activities will be presented in a videotherapy way.
Group 1	Physical practice	Post-stroke participants receive the mental practice before the physical practice. The activities will be presented in a videotherapy way.
Group 1	Mental practice	Post-stroke participants receive the mental practice before the physical practice. The activities will be presented in a videotherapy way.
Group 2	Mental practice	Post-stroke participants receive the mental practice after the physical practice. The activities will be presented in a videotherapy way.
Group 2	Videotherapy	Post-stroke participants receive the mental practice after the physical practice. The activities will be presented in a videotherapy way.

Primary Outcome Measures

Name	Time	Method
Fugl-Meyer Scale	Change from baseline sensory-motor impairmente at 8 weeks and 3 months (follow-up).	Sensory-motor impairment of upper limb
surface electromyography	change from baseline muscle activity at 8 weeks and 3 months (follow-up)	Short radial extensor of the carpus and superficial flexor of the fingers
Functional independence measure (FIM)	change from baseline functional independence at 8 weeks and 3 months (follow-up)	assess the dependence of others for activities of daily living
Action Research Arm Test (ARAT)	change from baseline dexterity at 8 weeks and 3 months (follow-up)	functional test of upper limb
Box and Block test (BBT)	change from baseline dexterity at 8 weeks and 3 months (follow-up)	manual dexterity

Secondary Outcome Measures

Name	Time	Method
Movement Imagery Questionnaire-Revised second version (MIQ-RS)	change from baseline ability to imagine at 8 weeks	evaluate the ability to imagine thick movements related to the upper and include movements referring to the ADLs.
Kinesthetic and Visual Imagery Questionnaire (KVIQ - 10)	change from baseline capacity of imagination at 8 weeks	assessing visual and kinesthetic motor imagery
Mini-mental State Examination	baseline	evaluation of cognition
Theory of Mind Task Battery (ToM)	change from mental function baseline at 8 weeks	evaluation of mental function
Modified ashworth scale (MAS)	change fom baseline muscle tone at 8 weeks and 3 months (follow-up)	evaluation of muscle tone of upper limb

Trial Locations

Locations (1)

Faculty of Health Science - Facisa/UFRN; 🇧🇷 Santa Cruz, Rio Grande do Norte, Brazil