Since you are using subjective measurement scales(Fugl-Meter and Modified Ashworth Scale) nothing here inspires any sort of confidence. In fact I would assume that the participants are using the Hawthorne effect to please the researchers.
Fuminari Kaneko1,2*,
Keiichiro Shindo1,2,
Masaki Yoneta1,2,3,
Megumi Okawada1,2,3,
Kazuto Akaboshi
1,2,3 and
Meigen Liu
1
- 1Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
- 2Department of Rehabilitation, Shonan Keiiku Hospital, Fujisawa, Japan
- 3Hokuto Social Medical Corporation, Obihiro, Japan
Barring a few studies, there are not enough established treatments to
improve upper limb motor function in patients with severe impairments
due to chronic stroke. This study aimed to clarify the effect of the
kinesthetic perceptional illusion induced by visual stimulation (KINVIS)
on upper limb motor function and the relationship between motor
function and resting-state brain networks. Eleven patients with severe
paralysis of upper limb motor function in the chronic phase (seven men
and four women; age: 54.7 ± 10.8 years; 44.0 ± 29.0 months post-stroke)
participated in the study. Patients underwent an intervention consisting
of therapy using KINVIS and conventional therapeutic exercise (TherEX)
for 10 days. Our originally developed KiNvis™ system was applied to
induce KINVIS while watching the movement of the artificial hand.
Clinical outcomes were examined to evaluate motor functions and
resting-state brain functional connectivity (rsFC) by analyzing
blood-oxygen-level-dependent (BOLD) signals measured using functional
magnetic resonance imaging (fMRI). The outcomes of motor function
(Fugle-Meyer Assessment, FMA) and spasticity (Modified Ashworth Scale,
MAS) significantly improved after the intervention. The improvement in
MAS scores for the fingers and the wrist flexors reached a minimum of
clinically important differences. Before the intervention, strong and
significant negative correlations between the motor functions and rsFC
of the inferior parietal lobule (IPL) and premotor cortex (PMd) in the
unaffected hemisphere was demonstrated. These strong correlations were
disappeared after the intervention. A negative and strong correlation
between the motor function and rsFC of the bilateral inferior parietal
sulcus (IPS) significantly changed to strong and positive correlation
after the intervention. These results may suggest that the combination
approach of KINVIS therapy and TherEX improved motor functions and
decreased spasticity in the paralyzed upper extremity after stroke in
the chronic phase, possibly indicating the contribution of
embodied-visual stimulation. The rsFC for the interhemispheric IPS and
intrahemispheric IPL and PMd may be a possible regulatory factor for
improving motor function and spasticity.
Clinical Trial Registration:
www.ClinicalTrials.gov, identifier NCT01274117.
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