Stroke, Stroke Sequelae
Conditions
Brief summary
Among the limitations caused by cerebrovascular accident (CVA), the upper limb (MS) undergoes changes that limit the individual in his ability to maintain an active social life. Mental Practice (MP) consists of the internal reproduction of an event, which is repeated extensively in order to learn or improve an already known skill. The objective of the study is evaluate the effects of the physical practice associated with PM, on paretic MS. Subjects with unilateral stroke over 6 months, age\> 18 years and who were able to hold objects will be selected. Subjects with painful conditions that affected exercise performance,\> 3 spasticity by Ashworth, and cognitive deficit suggested by the Mini Mental State Examination will be excluded.
Detailed description
There are 3 study protocols. The MP protocol 1 comprise 4 steps: 1) 5 minutes of global relaxation; 2) Video therapy, being 2 minutes / task (4 distinct tasks: stacking cubes, opposition of fingers with precision gripping, passing water from one glass to another, sequencing of bottles); 3) MP: think about the tasks assisted in the video for 5 minutes / task. 4) Physical Practice: reproduce through the motor execution, the activities assisted in the video (5 minutes / task). The MP protocol 2 was the same, changing the order: first physical practice and after MP. For the protocol 3 without PM, step 3 was suppressed, remaining the remaining steps. There were 15 sessions, 2x / week, for 1 hour. The Fugl-Meyer (FM) Scales, Ashworth Modified Scale (EMA), Functional Independence Measurement (MIF), Action Research Arm Test (ARAt), Box and block task (BBT) and Theory of mind battery (ToM) will be applied before and after the sessions, and in 3 months follow-up.
Interventions
OTHERPhysical practice
Physical Practice: reproduce through the motor execution (4 distinct tasks: stacking cubes, opposition of fingers with precision gripping, passing water from one glass to another, sequencing of bottles), the activities assisted in the video (5 minutes / task).
OTHERMental practice
Mental practice: think about the tasks watched in the videotherapy (4 distinct tasks: stacking cubes, opposition of fingers with precision gripping, passing water from one glass to another, sequencing of bottles) for 5 minutes / task.
OTHERVideotherapy
Videotherapy, being 2 minutes per task (4 distinct tasks: stacking cubes, opposition of fingers with precision gripping, passing water from one glass to another, sequencing of bottles)
Sponsors
Universidade Federal do Rio Grande do Norte
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Clinical diagnosis of stroke, ischemic or hemorrhagic, for more than 6 months, age above 18 years, unilateral involvement and are able to hold objects
Exclusion criteria
* Painful conditions that affect the ability to perform the proposed exercises, spasticity greater than 3 by the Ashworth Scale and cognitive deficits that will be evaluated by the Mini Mental State Examination (MMSE)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Box and Block test (BBT) | change from baseline dexterity at 8 weeks and 3 months (follow-up) | manual dexterity |
| Fugl-Meyer Scale | Change from baseline sensory-motor impairmente at 8 weeks and 3 months (follow-up). | Sensory-motor impairment of upper limb |
| surface electromyography | change from baseline muscle activity at 8 weeks and 3 months (follow-up) | Short radial extensor of the carpus and superficial flexor of the fingers |
| Functional independence measure (FIM) | change from baseline functional independence at 8 weeks and 3 months (follow-up) | assess the dependence of others for activities of daily living |
| Action Research Arm Test (ARAT) | change from baseline dexterity at 8 weeks and 3 months (follow-up) | functional test of upper limb |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Movement Imagery Questionnaire-Revised second version (MIQ-RS) | change from baseline ability to imagine at 8 weeks | evaluate the ability to imagine thick movements related to the upper and include movements referring to the ADLs. |
| Kinesthetic and Visual Imagery Questionnaire (KVIQ - 10) | change from baseline capacity of imagination at 8 weeks | assessing visual and kinesthetic motor imagery |
| Mini-mental State Examination | baseline | evaluation of cognition |
| Theory of Mind Task Battery (ToM) | change from mental function baseline at 8 weeks | evaluation of mental function |
| Modified ashworth scale (MAS) | change fom baseline muscle tone at 8 weeks and 3 months (follow-up) | evaluation of muscle tone of upper limb |
Countries
Brazil
Outcome results
None listed