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.
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
30
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).
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.
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)
Faculty of Health Science - Facisa/UFRN
Santa Cruz, Rio Grande do Norte, Brazil
Fugl-Meyer Scale
Sensory-motor impairment of upper limb
Time frame: Change from baseline sensory-motor impairmente at 8 weeks and 3 months (follow-up).
surface electromyography
Short radial extensor of the carpus and superficial flexor of the fingers
Time frame: change from baseline muscle activity at 8 weeks and 3 months (follow-up)
Functional independence measure (FIM)
assess the dependence of others for activities of daily living
Time frame: change from baseline functional independence at 8 weeks and 3 months (follow-up)
Action Research Arm Test (ARAT)
functional test of upper limb
Time frame: change from baseline dexterity at 8 weeks and 3 months (follow-up)
Box and Block test (BBT)
manual dexterity
Time frame: change from baseline dexterity at 8 weeks and 3 months (follow-up)
Movement Imagery Questionnaire-Revised second version (MIQ-RS)
evaluate the ability to imagine thick movements related to the upper and include movements referring to the ADLs.
Time frame: change from baseline ability to imagine at 8 weeks
Kinesthetic and Visual Imagery Questionnaire (KVIQ - 10)
assessing visual and kinesthetic motor imagery
Time frame: change from baseline capacity of imagination at 8 weeks
Mini-mental State Examination
evaluation of cognition
Time frame: baseline
Theory of Mind Task Battery (ToM)
evaluation of mental function
Time frame: change from mental function baseline at 8 weeks
Modified ashworth scale (MAS)
evaluation of muscle tone of upper limb
Time frame: change fom baseline muscle tone at 8 weeks and 3 months (follow-up)
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