13-2 Motor Imagery Practice for Improving Sit-to-Stand
Motor Imagery Practice for Improving Sit-to-Stand and Reach-to-Grasp in Individuals with Post-Stroke Hemiparesis
Avia Guttman1, Arie Burstin, Riki Brown, Shay Brill, Ruth Dickstein
Motor imagery practice refers to the mental rehearsal of motor act(s) in the absence of actual movement production. It is applied for the relearning or the improvement of specific motor tasks. Its merits lie in safety, ease of application, availability and low cost.
Study aims: To elucidate the contribution of motor imagery practice of sit-to-stand (STS) and of reach-to-grasp in subjects with post-stroke chronic hemiparesis.
Methods: The study was carried out in a day hospital setting in Israel. The participants were thirteen outpatients with chronic hemiparesis. The average age was 68.9 (± 4.9) years. Study design was a crossover intervention design.
Study protocol: Following one week of baseline measurements of performance, the two functions were mentally practiced for four weeks, three times a week, with half of the subjects mentally exercising STS and the second half practicing reachto- grasp. Subsequently, during the 5th - 9th week of the intervention, the participants in each group “crossed over” to practice the second function. All practice sessions were performed according to a pre-established protocol under close supervision. Measurements of real performance took place twice before and twice immediately following each practice session. For STS, the Tetrax Balance System was used to measure weight distribution and speed of STS. Reach-to-grasp was evaluated using the P-5 kinematic glove and included measurement of the speed variables of the hand.
Results: Following four weeks training of STS, significant improvement (p<0.001) was found in values of temporal variables, global STS duration time, transfer phase time and stabilization phase time. Weight distribution between legs was not affected by the intervention. There was a clear improvement in Fugl-Meyer of the lower limb and in the TUG. Test. Following four weeks training of reach-to-grasp, significant improvement (p<0.001) was found in values of mean and maximum reaching velocity, and time to maximum reaching velocity. There was a clear improvement in Fugl- Meyer of the upper limb, and in the Reaching Performance Scale. Discussion and conclusions: In individuals with chronic hemiparesis, imagery practice of meaningful motor tasks positively affects real performance. However, transfer and retention of practice gains is still an open question awaiting further research.
Key words: motor imagery, stroke, sit-to-stand,reaching duration time.