Effects of Mental Practice for Mobility in Post-stroke Hemiparesis

NCT ID: NCT02540096

Last Updated: 2019-05-23

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

16 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-11-30

Study Completion Date

2020-07-31

Brief Summary

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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

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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.

Conditions

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Stroke Hemiparesis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Investigators Outcome Assessors

Study Groups

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Intervention (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.

Group Type EXPERIMENTAL

Mental practice

Intervention Type OTHER

The sessions will be individualized and carried out in a peaceful setting.The aim of the mental practice protocol was to promote motor imagery of the following activities: get up from a chair and walk and sit, which enrolls the basic and instrumental activities of daily living. The sessions will consist of six steps: (1) "Physical Practice" (2) "Familiarization" (3) "Memory" (4) "Relaxation" (5) "Repeat" and (6) "post-practice mental relaxation". After the mental practice session, participants will be submitted to individual and structured physiotherapy sessions (the same as the control groups).

Control group

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.

Group Type PLACEBO_COMPARATOR

Cognitive training and Relaxation

Intervention Type OTHER

Cognitive training and relaxation session (lasting 30 minutes, three times a week), totaling 12 sessions. The sessions will consist of calculations, memorization, imagination and body relaxation exercises. These sessions will not have any motor imagery. After the cognitive training and relaxation session, participants will be submitted to individual and structured physiotherapy sessions lasting 40 minutes with muscle strengthening and stretching exercises.

Interventions

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Mental practice

The sessions will be individualized and carried out in a peaceful setting.The aim of the mental practice protocol was to promote motor imagery of the following activities: get up from a chair and walk and sit, which enrolls the basic and instrumental activities of daily living. The sessions will consist of six steps: (1) "Physical Practice" (2) "Familiarization" (3) "Memory" (4) "Relaxation" (5) "Repeat" and (6) "post-practice mental relaxation". After the mental practice session, participants will be submitted to individual and structured physiotherapy sessions (the same as the control groups).

Intervention Type OTHER

Cognitive training and Relaxation

Cognitive training and relaxation session (lasting 30 minutes, three times a week), totaling 12 sessions. The sessions will consist of calculations, memorization, imagination and body relaxation exercises. These sessions will not have any motor imagery. After the cognitive training and relaxation session, participants will be submitted to individual and structured physiotherapy sessions lasting 40 minutes with muscle strengthening and stretching exercises.

Intervention Type OTHER

Eligibility Criteria

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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.
Minimum Eligible Age

18 Years

Maximum Eligible Age

73 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Federal University of Juiz de Fora

OTHER

Sponsor Role lead

Responsible Party

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Zaqueline F. Guerra

MSc

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Zaqueline F Guerra

Role: PRINCIPAL_INVESTIGATOR

Federal University of Juiz de Fora

Locations

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Zaqueline Fernandes Guerra

Juiz de Fora, , Brazil

Site Status

Countries

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Brazil

References

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Paolucci S, Antonucci G, Grasso MG, Morelli D, Troisi E, Coiro P, Bragoni M. Early versus delayed inpatient stroke rehabilitation: a matched comparison conducted in Italy. Arch Phys Med Rehabil. 2000 Jun;81(6):695-700. doi: 10.1016/s0003-9993(00)90095-9.

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Zhang S, He WB, Chen NH. Causes of death among persons who survive an acute ischemic stroke. Curr Neurol Neurosci Rep. 2014 Aug;14(8):467. doi: 10.1007/s11910-014-0467-3.

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Page SJ, Dunning K, Hermann V, Leonard A, Levine P. Longer versus shorter mental practice sessions for affected upper extremity movement after stroke: a randomized controlled trial. Clin Rehabil. 2011 Jul;25(7):627-37. doi: 10.1177/0269215510395793. Epub 2011 Mar 22.

Reference Type BACKGROUND
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Reference Type BACKGROUND
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Malouin F, Richards CL, Jackson PL, Lafleur MF, Durand A, Doyon J. The Kinesthetic and Visual Imagery Questionnaire (KVIQ) for assessing motor imagery in persons with physical disabilities: a reliability and construct validity study. J Neurol Phys Ther. 2007 Mar;31(1):20-9. doi: 10.1097/01.npt.0000260567.24122.64.

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Malouin F, Richards CL, Doyon J, Desrosiers J, Belleville S. Training mobility tasks after stroke with combined mental and physical practice: a feasibility study. Neurorehabil Neural Repair. 2004 Jun;18(2):66-75. doi: 10.1177/0888439004266304.

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Malouin F, Richards CL, Durand A, Doyon J. Added value of mental practice combined with a small amount of physical practice on the relearning of rising and sitting post-stroke: a pilot study. J Neurol Phys Ther. 2009 Dec;33(4):195-202. doi: 10.1097/NPT.0b013e3181c2112b.

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Malouin F, Richards CL, Durand A, Doyon J. Clinical assessment of motor imagery after stroke. Neurorehabil Neural Repair. 2008 Jul-Aug;22(4):330-40. doi: 10.1177/1545968307313499. Epub 2008 Mar 6.

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Dunsky A, Dickstein R, Marcovitz E, Levy S, Deutsch JE. Home-based motor imagery training for gait rehabilitation of people with chronic poststroke hemiparesis. Arch Phys Med Rehabil. 2008 Aug;89(8):1580-8. doi: 10.1016/j.apmr.2007.12.039.

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Braun S, Kleynen M, van Heel T, Kruithof N, Wade D, Beurskens A. The effects of mental practice in neurological rehabilitation; a systematic review and meta-analysis. Front Hum Neurosci. 2013 Aug 2;7:390. doi: 10.3389/fnhum.2013.00390. eCollection 2013.

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Ietswaart M, Johnston M, Dijkerman HC, Joice S, Scott CL, MacWalter RS, Hamilton SJ. Mental practice with motor imagery in stroke recovery: randomized controlled trial of efficacy. Brain. 2011 May;134(Pt 5):1373-86. doi: 10.1093/brain/awr077. Epub 2011 Apr 22.

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Guerra ZF, Bellose LC, Ferreira AP, Faria CDCM, Paz CCSC, Lucchetti G. Effects of mental practice on mobility of individuals in the early subacute post-stroke phase: A randomized controlled clinical trial. J Bodyw Mov Ther. 2022 Oct;32:82-90. doi: 10.1016/j.jbmt.2022.04.018. Epub 2022 Apr 27.

Reference Type DERIVED
PMID: 36180164 (View on PubMed)

Other Identifiers

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43659515.4.0000.5103

Identifier Type: -

Identifier Source: org_study_id

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