Comparative Effects of Motor Imagery and Mirror Therapy Versus Motor Relearning Program on Balance, Motor Function and Activities of Daily Living in Subacute Stroke Patients
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Enrollment
- 50
- Locations
- 1
- Primary Endpoint
- FUGL-MEYER ASSESMENT (FMA)
Study Overview
Brief Summary
Use of motor imagery, mirror therapy and motor relearning program in rehabilitation of people with stroke is on rise and these are unique and emerging techniques. Motor imagery is a mental rehearsal through visualization while mirror therapy creates a reflection of non-effected limb by using a mirror. Moreover, motor relearning is task-oriented approach, benefacial for balance and motor funCtion in patients with stroke that emphasizes on relearning.The aim of the study is to determine the comparative effects of motor imagery and mirror therapy versus motor relearning program in addition to routine physical therapy on balance, motor function and activities of daily living in subacute stroke patients.
Detailed Description
This randomized clinical trial will be conducted at medical centre Fifty stroke patients will be included using convenience sampling technique. The participants in the study will be randomly allocated in to two groups . Twenty five participants will be included in both Groups A d B. Group A (motor imagery and mirror therapy) will receive 60 minutes treatment session that consists of 20 minutes motor imagery, 20 minutes mirror therapy along with 20 minutes routine physical therapy and Group B (motor relearning program) will receive treatment session of 60 minutes including motor relearning program of 40 minutes duration along with routine physical therapy of 20 minutes. Both groups will undergo 60 minutes session for 5 days per week for 12 weeks. Berg balance scale will be used to assess balance, Fugl-meyer assessment to assess motor function and Functional independence measure for activities of daily living. Assessment will be carried out at baseline, 4th week, 8th week and at 12th week after the discontinuation of treatment.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Single (Outcomes Assessor)
Masking Description
The study would be single blinded as assessor of the study would be kept blind of the treatment groups to which patient would be allocated.
Eligibility Criteria
- Ages
- 40 Years to 65 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Stroke patient of both gender.
- •Stroke patient of age 40-65 year .
- •Patient diagnosis of cerebral ischemic stroke .
- •Patients who had suffered a stroke with hemiplegia, were subacute at least 3 months to 5 months since the onset.
- •Ability to walk with minimal assistance (functional ambulation category 1 to
- •Patient with score > 25 on mini-mental status examination.
Exclusion Criteria
- •Patients who presented with hemiplegic neglect or apraxia
- •Patients with history of global or receptive aphasia
- •Patients with history of psychological or emotional problems
- •Patients with history of decompensated cardiovascular/ respiratory/ digestive/ renal disorders, biologic inflammatory syndrome, neoplastic disorders, neurogenic bladder or skin disorders (bedsores).
- •Patients with history of artificial joints
Arms & Interventions
GROUP A (MOTOR IMAGERY+MIRROR THERAPY+ROUTINE PHYSICAL THERAPY)
Group A will receive treatment session of 60 minutes including motor imagery for 20 minutes and mirror therapy for 20 minutes along with routine physical therapy of 20 minutes for 5 days per week for 12 weeks.In motor imagery subjects will watch the video and will be asked to close the eyes to focus and imagine how they are doing task they had previously observed 10 times and instructed to carry out the task in verbal commands given whenever necessary.
In mirror therapy,The unaffected limb will be placed in front of the mirror and patient will try to make the identical motions with the paretic limb while moving the non-paretic limb during the session and routine physical therapy includes passive and active assisted range of motion for the upper and lower extremity including the shoulder, forearm, wrist, hip, knee and ankle will be given (10 - 15 repititions).
Intervention: MOTOR IMAGERY+MIRROR THERAPY+ROUTINE PHYSICAL THERAPY (Other)
GROUP B (MOTOR RELEARNING PROGRAM+ROUTINE PHYSICAL THERAPY)
GROUP B will receive treatment session of 60 minutes including motor relearning program of 40 minutes duration along with routine physical therapy of 20 minutes as explained in group A protocol. Treatment session will be given 5 days per week for 12 weeks.
Motor relearning consists of five components including analysis of task, practice of missing components, practice of task and transference of training.
Intervention: MOTOR RELEARNING PROGRAM+ROUTINE PHYSICAL THERAPY (Other)
Outcomes
Primary Outcomes
FUGL-MEYER ASSESMENT (FMA)
Time Frame: 12th week
The Fugl-Meyer Assessment is a welldesigned, feasible and efficient clinical examination method that has been tested widely in the stroke population. A three-level ordinal scale (0, can perform no part of the test; 1, performs test partially; 2, performs test normally) is applied to each item. A total possible score for the lower extremity is 34. The higher the score, the better the performance.
FUNCTIONAL INDEPENDENCE MEASURE (FIM)
Time Frame: 12th week
The Functional Independence Measure (FIM) is one of the most frequently used outcome measures in stroke rehabilitation trials. The five FIM items dealing with transfers and locomotion, including transfers to bed/chair/wheelchair, toileting, bathing, walking or wheelchair management and stairs, were used in this pilot study to evaluate the activities of daily living in the patients with stroke. Each item is rated on a seven-level scale, with 1 = total assistance and 7 (complete independence). By adding the points for each item in the transfers and locomotion, the possible total score ranges from 5 (lowest) to 35 (highest) level of independence; the higher the score, the better the independence. This scale has good reliability for the assessment of recovery of function in stroke patients.
Berg balance scale (BBS)
Time Frame: 12th week
The BBS is postural balance scale containing 14 items including standing and sitting unsupported, reaching forward, and placing the alternating foot on a stool. Administering the BBS takes approximately 15 min. Each of the 14 items are scored on a 5-level ordinal scale from 0 ("unable to perform or requiring help") to 4 ("normal performance"), thus providing a potential maximum score of 56 points
Secondary Outcomes
No secondary outcomes reported