Motor Imagery Training for Upper Limb Functional Strength in Chronic Stroke Patients

NCT ID: NCT06945185

Last Updated: 2025-04-25

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 26 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-09-10
• Study Completion Date: 2025-05-30

Brief Summary

Stroke is a leading cause of upper extremity deficits worldwide. Persistent upper extremity dysfunction affects many post stroke patients and is strongly associated with decreased activities of daily living and poor quality of life.

There is accumulating evidence of a cross-over effect with training of one limb that slightly increase strength and coordination in contralateral untrained limb through neurological adaptations.

One of rehabilitation that is beneficial for stroke patient is motor imagery, a mental rehearsal of a movement that does not include physical movement has been shown to enhance upper limb function.

Evidence demonstrate that MI not only activates motor cortical and subcortical regions but also induces plastic change in motor networks and modulates synaptic activity at spinal level.

Detailed Description

OBJECTIVE:

The objectives of this study are:

1. To improve upper limb functional strength.

2. To improve the upper limb coordination.

3. To improve upper limb functional improvement.

HYPOTHESIS

Alternate Hypothesis:

There will be statistically significant difference in effects of motor imagery technique combined with conventional physical therapy and in comparison to conventional physical therapy alone on upper limb functional strength, coordination and functional improvement in chronic stroke. (p<0.05).

Null Hypothesis:

There will be no statistically significant difference in effects of motor imagery technique combined with conventional physical therapy and in comparison to conventional physical therapy alone on upper limb functional strength, coordination and functional improvement in chronic stroke. (p>0.05).

Research Design: Experimental study. Randomized Control Trial

Conditions

Chronic Stroke

Study Design

• Allocation Method: NA
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

CONTROL GROUP A- CONVENTIONAL PHYSICAL THERAPY

The participants will receive conventional physical therapy focusing on active range of motion, strengthing and coordination exercises.

Subjects will receive protocol of 45 min thrice a week for 8 weeks with 2 min rest in between.

The exercises will focus on active range of motion, weight exercises to increase strength and coordination exercises to improve movement coordination.

Group Type: ACTIVE_COMPARATOR

Intervention Group A Conventional Physical Therapy

Intervention Type: PROCEDURE

Active Range of Motion Exercises: (5-10 reps with 2 sets) Finger bends, finger spreads, finger to thumb opposition, thumb to palm stretches, palm up and down, wrist rotation, wrist bends, elbow bends, shoulder shrugging and shoulder rotation.

Strengthening Exercises: (10-15 reps 2 sets weight 500 ml to 1L water bottle). Finger pinch, power grip, finger spread, pushing movement, wrist curls, roll and squeeze, bicep curls, side arm raise, lifting objects to a height, pulling resistance band.

Coordination Exercises: (10-15 reps 2 sets) finger to finger, finger to doctor's finger, finger to nose, holding and lifting coins, buttoning, holding and lifting coins, alternate hand movement, closing and opening hand.

INTERVENTION GROUP B- MOTOR IMAGERY WITH CONVENTIONAL PHYSICAL

The participants will recieve conventional physical therapy focusing on active range of motion, strengthing and coordination exercises.

Subjects will recieve protocal of 45 min thrice a week for 8 weeks with 2 min rest in between.

The exercises will focus on active range of motion, weight exercises to increase strength and coordination exercises to improve movement coordination.

Group Type: EXPERIMENTAL

Intervention Group B Motor Imagery with Conventional Physical Therapy

Intervention Type: PROCEDURE

1. Subjects will be asked to sit comfortably on a chair with a backrest. A Quiet environment is ensured for proper concentration of subject .Take deep breaths for 2-3 min to relax.

2. Subjects will be asked to close their eyes and imagine the training scene for each task for 5 min while listening to the therapist 's voice describing the motion.

3. The non-paralysis part of the body's movement was imagined first and then the movement of the paralysis part was imagined.

4. Upon completion of the mental practice for the first activity, the subject will be given a comfortable break.

Motor Imagery Training:

Week 1-2: Approaching and holding a cup, turning book pages and grasping pencil to write.

Week 3-4: wiping desk, turning door handle and drinking water from cup. Week 5-6: pressing light switch on and off, turning faucet and putting card in wallet.

Week 7-8: folding towel, brushing teeth and brushing hair. Imagine for 30 sec 2-3 repetitions.

Interventions

Intervention Group A Conventional Physical Therapy

Active Range of Motion Exercises: (5-10 reps with 2 sets) Finger bends, finger spreads, finger to thumb opposition, thumb to palm stretches, palm up and down, wrist rotation, wrist bends, elbow bends, shoulder shrugging and shoulder rotation.

Strengthening Exercises: (10-15 reps 2 sets weight 500 ml to 1L water bottle). Finger pinch, power grip, finger spread, pushing movement, wrist curls, roll and squeeze, bicep curls, side arm raise, lifting objects to a height, pulling resistance band.

Coordination Exercises: (10-15 reps 2 sets) finger to finger, finger to doctor's finger, finger to nose, holding and lifting coins, buttoning, holding and lifting coins, alternate hand movement, closing and opening hand.

Intervention Type: PROCEDURE

Intervention Group B Motor Imagery with Conventional Physical Therapy

1. Subjects will be asked to sit comfortably on a chair with a backrest. A Quiet environment is ensured for proper concentration of subject .Take deep breaths for 2-3 min to relax.

2. Subjects will be asked to close their eyes and imagine the training scene for each task for 5 min while listening to the therapist 's voice describing the motion.

3. The non-paralysis part of the body's movement was imagined first and then the movement of the paralysis part was imagined.

4. Upon completion of the mental practice for the first activity, the subject will be given a comfortable break.

Motor Imagery Training:

Week 1-2: Approaching and holding a cup, turning book pages and grasping pencil to write.

Week 3-4: wiping desk, turning door handle and drinking water from cup. Week 5-6: pressing light switch on and off, turning faucet and putting card in wallet.

Week 7-8: folding towel, brushing teeth and brushing hair. Imagine for 30 sec 2-3 repetitions.

Intervention Type: PROCEDURE

Eligibility Criteria

Inclusion Criteria

• Stroke duration 6 months onwards (chronic stroke).
• age 45 years and above.
• Both genders.
• Access cognitive function score > 24 on MoCA.

Exclusion Criteria

• Patients with any comorbidity, previous surgery and congenital anomly.
• Patient with any fracture/ MSK disorders.
• Score 3 or more on Modified Ashworth scale.
• Patients with hearing impairments

• Minimum Eligible Age: 45 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Foundation University Islamabad

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Locations

Foundation University College of Physical Thrapy

Islamabad, , Pakistan

Site Status: RECRUITING

Countries

Pakistan

Central Contacts

AYESHA ASIF, DPT

Role: CONTACT

ayesha97asif@gmail.com

+92 316-5314207

Facility Contacts

Sana Khalid, MS-NMPT

Role: primary

sana.khalid@fui.edu.pk

+92 344-4218174

Other Identifiers

FUI/CTR/2024/64

Identifier Type: -

Identifier Source: org_study_id