In the study, movement observation training, Modified Graded Motor Imaging Training, which includes upper extremity functional exercises, and Graded Motor Imaging Training, where the standard protocol is applied, will be used in stroke patients to improve their upper extremity motor functions and daily lives. It is aimed to present it on an evidence-based basis by investigating its effects on Daily Living Activity, quality of life, upper extremity-specific right/left lateralization performance, mental stopwatch performance and motor imagery skills.
At study is planned as a combination of action observation training, motor imagery and graded motor imagery training, which have come to the fore in recent years and whose importance increases with each passing year. Additionally, its preferability in treatment will be investigated by comparing it with Graded Motor Imagery training, in which the standard protocol is applied. It is anticipated that treatment protocols will shed light on future studies. The hypotheses of the study are as follows: Hypothesis 1: Modified Graded Motor Imagery training is more effective than Graded Motor Imagery training and conventional treatment in improving upper extremity motor functions in individuals with stroke. Hypothesis 2: Modified Graded Motor Imagery training is more effective than Graded Motor Imagery training and conventional treatment in improving daily living activities in individuals with stroke. Hypothesis 3: Modified Graded Motor Imagery training is more effective than Graded Motor Imagery training and conventional treatment in improving the quality of life in individuals with stroke. Hypothesis 4: Modified Graded Motor Imagery training is more effective than Graded Motor Imagery training and conventional treatment in improving motor imagery skills in individuals with stroke. Design of the study: The study was designed as a randomized controlled study.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
21
A modified form of graded motor imagery training and conventional rehabilitation will be applied.
Graded motor imagery training and conventional rehabilitation will be applied.
conventional rehabilitation will be applied.
Inonu University
Malatya, Turkey (Türkiye)
Fugl-Meyer Upper Extremity Motor Rating Scale
The scale is a widely used, reliable and valid test to evaluate paretic upper extremity motor impairment in stroke patients. From this scale, where each parameter is scored between 0-2 points, a maximum score of 66 can be obtained, and high scores indicate good motor functions.
Time frame: before treatment, 2 months, 4 months
Wolf Motor Function Test (WMFT)
WMFT is used to evaluate motor skill in patients with upper extremity motor dysfunction. The 15 functional activities evaluated are scored between 0-5 points and the functional skill score is calculated by taking the average of the total score. Higher scores indicate better functional ability. In the performance time section, how long each activity took is recorded. A maximum of 120 seconds is allowed to complete an activity. If the activity cannot be completed within this time, the performance time is recorded as 120 seconds.
Time frame: before treatment, 2 months, 4 months
Modified Barthel Index
MBI, which is used to measure the independence of individuals in daily living activities, emerged by modifying the Barthel Index. MBI includes 10 items related to activities of daily living. Total score is between 0-100. As the score increases, individuals' independence in daily living activities increases.
Time frame: before treatment, 2 months, 4 months
Stroke-Specific Quality of Life Scale
It consists of a total of 49 items for 12 subcategories (mobility, fitness, upper extremity functionality, work/productivity, mood, self-care, social roles, family roles, language, vision, thinking and personality) that evaluate the quality of life of individuals with stroke. The higher the total score, the better the stroke individual's quality of life.
Time frame: before treatment, 2 months, 4 months
Lateralization Assessment
Right/left lateralization performance of the upper extremity will be evaluated with the "Recognise™" application developed by the Neuro Orthapedic Institute. The "Recognise™ Hand" and "Recognise™ Shoulder" sections of this application and the "Vanilla" part of these sections will be used. Accuracy rates and reaction time in the application will be recorded. An increase in the accuracy rate indicates that lateralization performance has improved.
Time frame: before treatment, 2 months, 4 months
Mental Chronometry Time
It will be used to evaluate the chronometric aspect of motor imagery. You will be given the task of wearing and folding a T-shirt for the mental stopwatch period.First, the motor imagery task will be performed. The time written on the screen is recorded by the observer. For the physical phase of the test, the same application is actually carried out and the time is recorded with the help of a stopwatch. Mental stopwatch rate will be calculated. Mental stopwatch ratio = (Time in which the movement is physically performed - Time in which the movement is performed with imagination) / Time in which the movement is physically performed.
Time frame: before treatment, 2 months, 4 months
Kinesthetic and Visual Imagery Questionnaire (KGIA)
CSIA will be used to evaluate motor imagery skills. After experiencing the movement in reality, he will be asked to imagine himself watching the same movement as if it were actually performed. Participants will evaluate the quality of the image in the visualization by giving points between 1 and 5, including "1 (no image)" and "5 (clear as the original)". An increase in the score indicates improvement.
Time frame: before treatment, 2 months, 4 months
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