Comparative Effects of Motor Imagery and Mirror Therapy Versus Motor Relearning Program in Subacute Stroke Patients

NCT ID: NCT06308211

Last Updated: 2024-10-15

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 50 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-02-25
• Study Completion Date: 2024-09-30

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.

Conditions

Stroke

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

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).

Group Type: EXPERIMENTAL

MOTOR IMAGERY+MIRROR THERAPY+ROUTINE PHYSICAL THERAPY

Intervention Type: OTHER

Subjects will be instructed to watch the video provided and recorded by investigator.In next step participants will be asked to close the eyes to focus and then to imagine how they are doing task they had previously observed 10 times.Participants will be than instructed to carry out the task in verbal commands given whenever necessary.The unaffected limb will be placed in front of the mirror so that the reflected illusion of the limb would be hallucinated to represent the affected limb 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).

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.

Group Type: EXPERIMENTAL

MOTOR RELEARNING PROGRAM+ROUTINE PHYSICAL THERAPY

Intervention Type: OTHER

Motor relearning consists of five components including analysis of task, practice of missing components, practice of task and transference of training. Patient will be asked to practice task in both sitting and standing

• supine to side-lying to sitting
• looking up at ceiling (ensure that centre of body mass does not move back when head is tilted back)
• without moving one's feet, turning to gaze over each other's shoulders and scanning the surroundings for specific items, reaching motions in multiple directions while moving the head and trunk, scooting in bed, altering the base of support (standing with your feet together, in tandem, with one foot on a step, or on one leg)
• squatting to pick up an object and cross over stepping 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).

Interventions

MOTOR IMAGERY+MIRROR THERAPY+ROUTINE PHYSICAL THERAPY

Subjects will be instructed to watch the video provided and recorded by investigator.In next step participants will be asked to close the eyes to focus and then to imagine how they are doing task they had previously observed 10 times.Participants will be than instructed to carry out the task in verbal commands given whenever necessary.The unaffected limb will be placed in front of the mirror so that the reflected illusion of the limb would be hallucinated to represent the affected limb 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 Type: OTHER

MOTOR RELEARNING PROGRAM+ROUTINE PHYSICAL THERAPY

Motor relearning consists of five components including analysis of task, practice of missing components, practice of task and transference of training. Patient will be asked to practice task in both sitting and standing

• supine to side-lying to sitting
• looking up at ceiling (ensure that centre of body mass does not move back when head is tilted back)
• without moving one's feet, turning to gaze over each other's shoulders and scanning the surroundings for specific items, reaching motions in multiple directions while moving the head and trunk, scooting in bed, altering the base of support (standing with your feet together, in tandem, with one foot on a step, or on one leg)
• squatting to pick up an object and cross over stepping 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 Type: OTHER

Other Intervention Names

Rehabilitation; Rehabilitation

Eligibility Criteria

Inclusion Criteria

1. Stroke patient of both gender.

2. Stroke patient of age 40-65 year .

3. Patient diagnosis of cerebral ischemic stroke .

4. Patients who had suffered a stroke with hemiplegia, were subacute at least 3 months to 5 months since the onset.

5. Ability to walk with minimal assistance (functional ambulation category 1 to 3.

6. Patient with score > 25 on mini-mental status examination.

Exclusion Criteria

1. Patients who presented with hemiplegic neglect or apraxia

2. Patients with history of global or receptive aphasia

3. Patients with history of psychological or emotional problems

4. Patients with history of decompensated cardiovascular/ respiratory/ digestive/ renal disorders, biologic inflammatory syndrome, neoplastic disorders, neurogenic bladder or skin disorders (bedsores).

5. Patients with history of artificial joints

• Minimum Eligible Age: 40 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Riphah International University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Muhammad Kashif, PhD

Role: STUDY_CHAIR

Riphah International University

Locations

Muhammad Kashif

Lahore, Punjab Province, Pakistan

Countries

Pakistan

Other Identifiers

REC/RCR&AHS/23/0289

Identifier Type: -

Identifier Source: org_study_id