Effects of Mental Practice for Mobility in Post-stroke Hemiparesis

Recruiting

Phase N/A Results N/A

Trial Description

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.

Detailed Description

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.

Conditions

Interventions

  • Physiotherapy Behavioral
    Other Names: Exercise
    Intervention Desc: Participants will be submitted to individual and structured physiotherapy sessions (lasting 40 minutes and three times a week), totaling 12 sessions at the end of this control intervention. These sessions will be carried out by a physical therapist not involved in the research. Participants will undergo strengthening exercises and muscle stretching for the major muscles of the affected leg and lower trunk.
    ARM 1: Kind: Experimental
    Label: Control group 1
    Description: Participants will be submitted to individual and structured physiotherapy sessions (lasting 40 minutes and three times a week), totaling 12 sessions at the end of this control intervention. These sessions will be carried out by a physical therapist not involved in the research.
    ARM 2: Kind: Experimental
    Label: Intervention (Mental Practice)
    Description: Participants will be submitted to individual and structured physiotherapy sessions (the same as the control groups). They will also participate in a structured mental practice session (lasting one hour and three times a week), totaling 12 sessions at the end of this intervention.
    ARM 3: Kind: Experimental
    Label: Control group 2
    Description: Participants will be submitted to individual and structured physiotherapy sessions (the same as the control groups). They will also participate in a cognitive training and relaxation session (lasting 60 minutes, three times a week), totaling 12 sessions.
  • Mental practice Other
    Intervention Desc: 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).
    ARM 1: Kind: Experimental
    Label: Intervention (Mental Practice)
    Description: Participants will be submitted to individual and structured physiotherapy sessions (the same as the control groups). They will also participate in a structured mental practice session (lasting one hour and three times a week), totaling 12 sessions at the end of this intervention.
  • Cognitive training and Relaxation Other
    Intervention Desc: 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.
    ARM 1: Kind: Experimental
    Label: Control group 2
    Description: Participants will be submitted to individual and structured physiotherapy sessions (the same as the control groups). They will also participate in a cognitive training and relaxation session (lasting 60 minutes, three times a week), totaling 12 sessions.
    ARM 2: Kind: Experimental
    Label: Control group
    Description: Participants will be submitted to individual and structured physiotherapy sessions lasting 40 minutes. They will also participate in a cognitive training and relaxation session (lasting 30 minutes, three times a week), totaling 12 sessions.

Trial Design

  • Allocation: Randomized
  • Masking: Double Blind (Investigator, Outcomes Assessor)
  • Purpose: Treatment
  • Endpoint: Efficacy Study
  • Intervention: Parallel Assignment

Outcomes

Type Measure Time Frame Safety Issue
Primary Change in Timed Up and Go (TUG) 1 week before intervention; 4 weeks after intervention; 6 weeks after intervention No
Primary 5-Meter Walk Test 1 week before intervention; 4 weeks after intervention; 6 weeks after intervention No
Secondary Change in Muscle strength 1 week before intervention; 4 weeks after intervention; 6 weeks after intervention No
Secondary Change in Quality of life 1 week before intervention; 4 weeks after intervention; 6 weeks after intervention No
Secondary Change in Mental health 1 week before intervention; 4 weeks after intervention; 6 weeks after intervention No
Secondary Change in TUG-ABS 1 week before intervention; 4 weeks after intervention; 6 weeks after intervention No

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