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.
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 Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
16
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).
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.
Zaqueline Fernandes Guerra
Juiz de Fora, Brazil
Change in Timed Up and Go (TUG)
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
Time frame: 1 week before intervention; 4 weeks after intervention; 6 weeks after intervention
5-Meter Walk Test
This is a measure that examines the participant's gait speed (cut off 6 seconds)
Time frame: 1 week before intervention; 4 weeks after intervention; 6 weeks after intervention
Change in Muscle strength
Hand-held dynamometer (HDD) for measuring lower-limb muscle strength
Time frame: 1 week before intervention; 4 weeks after intervention; 6 weeks after intervention
Change in Quality of life
Using World Health Organization Quality of Life Instrument (WHOQOL-Bref)
Time frame: 1 week before intervention; 4 weeks after intervention; 6 weeks after intervention
Change in Mental health
Using Depression, anxiety and stress scale (DASS-21)
Time frame: 1 week before intervention; 4 weeks after intervention; 6 weeks after intervention
Change in TUG-ABS
The Timed "Up and Go" Assessment of Biomechanical Strategies (TUG-ABS)
Time frame: 1 week before intervention; 4 weeks after intervention; 6 weeks after intervention
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