Effects of Mental Practice for Mobility in Post-stroke Hemiparesis

Not Applicable

• Conditions: Stroke; Hemiparesis
• Interventions: Other: Mental practice; Other: Cognitive training and Relaxation

• Registration Number: NCT02540096
• Lead Sponsor: Federal University of Juiz de Fora

Brief Summary

Stroke is a neurovascular event characterized by impaired blood supply to the brain due to rupture or obstruction of certain cerebral arteries, which often results in hemiparesis and can affect individuals of any age and sex, being prevalent in the elderly population.

Among the main treatments available for stroke rehabilitation, most of them demands an appropriate structure and high-qualified personnel. Searching for more affordable treatment options, several studies suggest the use of mental practice with motor imagery as a potential therapeutic tool, since it can be performed at any place or any time the patient wishes, including their own homes.

Motor imagery can be defined as the covert cognitive process of imagining a movement of your own body(-part) without actually moving that body(-part).

Within this context, the objective of this study is to investigate the effects of mental practice for mobility, gait function and speed and muscle strength of the lower limb in subacute post-stroke hemiparesis.

Detailed Description

Post-stroke patients will be invited to participate after hospital discharge, based on inclusion and exclusion criteria. Then, after acceptance, participants will be randomized (block strategy) into two groups: Control group (Physiotherapy and Cognitive mental exercise) and Intervention group (Physiotherapy and Mental Practice group).

At baseline, 4 weeks (end of intervention) and 6 weeks, participants will be evaluated through the following tests: Timed-Up and Go test, 5-Meter Walk Test, TUG-ABS, WHOQOL-Bref, DASS-21 and muscle strength.

Study Timeline

• Study First Submitted: 2015-09-01
• Study First Submitted QC: 2015-09-01
• Study First Posted: 2015-09-03
• Study Start: 2015-11
• Primary Completion: 2019-01
• Status Verified: 2019-05
• Last Update Submitted: 2019-05-21
• Last Update Posted: 2019-05-23
• Study Completion: 2020-07

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 16

Inclusion Criteria

• hemiparesis after ischemic stroke (15 to 180 days after the event);
• only one cerebral hemisphere affected;
• no chemical, alcohol or drug dependency;
• Score average ≥ 2,5 point in the instrument "Visual and Kinesthetic Imagery Questionnaire" (KIVQ-10);
• No cognitive impairment (18 points in the Mini-Mental State Examination - 0-4 years of educations and 24 points (>4 years of education);
• Not participating in any other type of physiotherapy or physical activity during the study period;
• Complaining of difficulty in gait and mobility after stroke;
• Able to stand up from a chair and walk some distance with or without auxiliary device;

Exclusion Criteria

• Hemorrhagic or ischemic progressing to hemorrhagic stroke;
• Score ≥ 4 on the Visual Analogue Pain Scale;
• Score ≥ 2 on the modificator Ashworth scale;
• Visual disabilities;
• Severe Aphasia;
• Cardiovascular instability and/or other neurological disorders that may impair the mobility and gait.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Intervention (Mental Practice)	Mental practice	Participants will be submitted to individual and structured physiotherapy sessions (the same as the control groups). They will also participate in a structured mental practice session (lasting 30 minutes and three times a week), totaling 12 sessions at the end of this intervention.
Control group	Cognitive training and Relaxation	Participants will be submitted to individual and structured physiotherapy sessions lasting 40 minutes. They will also participate in a cognitive training and relaxation session (lasting 30 minutes, three times a week), totaling 12 sessions.

Primary Outcome Measures

Name	Time	Method
Change in Timed Up and Go (TUG)	1 week before intervention; 4 weeks after intervention; 6 weeks after intervention	This is a measure that examines the participant's basic mobility skills by measuring seconds to rise from sitting, walk 3 meters, return, and sitting down
5-Meter Walk Test	1 week before intervention; 4 weeks after intervention; 6 weeks after intervention	This is a measure that examines the participant's gait speed (cut off 6 seconds)

Secondary Outcome Measures

Name	Time	Method
Change in Quality of life	1 week before intervention; 4 weeks after intervention; 6 weeks after intervention	Using World Health Organization Quality of Life Instrument (WHOQOL-Bref)
Change in Muscle strength	1 week before intervention; 4 weeks after intervention; 6 weeks after intervention	Hand-held dynamometer (HDD) for measuring lower-limb muscle strength
Change in Mental health	1 week before intervention; 4 weeks after intervention; 6 weeks after intervention	Using Depression, anxiety and stress scale (DASS-21)
Change in TUG-ABS	1 week before intervention; 4 weeks after intervention; 6 weeks after intervention	The Timed "Up and Go" Assessment of Biomechanical Strategies (TUG-ABS)

Trial Locations

Locations (1)

Zaqueline Fernandes Guerra; 🇧🇷 Juiz de Fora, Brazil