Influence of Mental Practice on Manual Dexterity Associated Before and After Physical Practice in Patients With Stroke Sequelae
Trial Snapshot
- Phase
- Not Applicable
- Enrollment
- 30
- Locations
- 1
- Primary Endpoint
- Fugl-Meyer Scale
Study Overview
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 Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
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)
Arms & Interventions
Group 1
Post-stroke participants receive the mental practice before the physical practice. The activities will be presented in a videotherapy way.
Intervention: Physical practice (Other)
Group 1
Post-stroke participants receive the mental practice before the physical practice. The activities will be presented in a videotherapy way.
Intervention: Mental practice (Other)
Group 1
Post-stroke participants receive the mental practice before the physical practice. The activities will be presented in a videotherapy way.
Intervention: Videotherapy (Other)
Group 2
Post-stroke participants receive the mental practice after the physical practice. The activities will be presented in a videotherapy way.
Intervention: Physical practice (Other)
Group 2
Post-stroke participants receive the mental practice after the physical practice. The activities will be presented in a videotherapy way.
Intervention: Mental practice (Other)
Group 2
Post-stroke participants receive the mental practice after the physical practice. The activities will be presented in a videotherapy way.
Intervention: Videotherapy (Other)
Group 3
Post-stroke participants receive only physical practice. The activities will be presented in a videotherapy way.
Intervention: Physical practice (Other)
Group 3
Post-stroke participants receive only physical practice. The activities will be presented in a videotherapy way.
Intervention: Videotherapy (Other)
Outcomes
Primary Outcomes
Fugl-Meyer Scale
Time Frame: Change from baseline sensory-motor impairmente at 8 weeks and 3 months (follow-up).
Sensory-motor impairment of upper limb
surface electromyography
Time Frame: 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)
Time Frame: 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)
Time Frame: change from baseline dexterity at 8 weeks and 3 months (follow-up)
functional test of upper limb
Box and Block test (BBT)
Time Frame: change from baseline dexterity at 8 weeks and 3 months (follow-up)
manual dexterity
Secondary Outcomes
- Movement Imagery Questionnaire-Revised second version (MIQ-RS)(change from baseline ability to imagine at 8 weeks)
- Kinesthetic and Visual Imagery Questionnaire (KVIQ - 10)(change from baseline capacity of imagination at 8 weeks)
- Mini-mental State Examination(baseline)
- Theory of Mind Task Battery (ToM)(change from mental function baseline at 8 weeks)
- Modified ashworth scale (MAS)(change fom baseline muscle tone at 8 weeks and 3 months (follow-up))
Investigators
Roberta de Oliveira Cacho
PhD
Universidade Federal do Rio Grande do Norte