Now we just need this written up in protocol format and delivered to all 10 million yearly stroke survivors and for all times in the past, since this is for chronic. Further research is required in order to establish how to get better community ambulation from this. It is a start and if we had stroke leadership we could be assured that a complete solution would be found. BUT WE HAVE NO STROKE LEADERSHIP.
Effects of Integrated Motor Imagery Practice on Gait of Individuals With Chronic Stroke: A Half-Crossover Randomized Study
Ruth Dickstein, DSc, a
Judith E. Deutsch, PhD, b
Yonat Yoeli, BSc, c
Michal Kafri, PhD, a
Faten Falash, BSc, c
Ayelet Dunsky, PhD, d
Adi Eshet, MSc, a
Neil Alexander, MD e
From the
a Department of Physical Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel;
b Rivers Lab,Department of Rehab and Movement Science, University of Medicine and Dentistry of New Jersey, Newark, NJ;
c Department of Physical Therapy, Flieman Geriatric Rehabilitation Hospital, Haifa, Israel;
d Zinman College for Physical Education and Sport Science, Wingate Institute,Netanya, Israel; and
e Geriatric Research, Education, and Clinical Center, Division of Geriatric Medicine and Research Institute of Gerontology,University of Michigan, Ann Arbor, MI.
Judith E. Deutsch, PhD, b
Yonat Yoeli, BSc, c
Michal Kafri, PhD, a
Faten Falash, BSc, c
Ayelet Dunsky, PhD, d
Adi Eshet, MSc, a
Neil Alexander, MD e
From the
a Department of Physical Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel;
b Rivers Lab,Department of Rehab and Movement Science, University of Medicine and Dentistry of New Jersey, Newark, NJ;
c Department of Physical Therapy, Flieman Geriatric Rehabilitation Hospital, Haifa, Israel;
d Zinman College for Physical Education and Sport Science, Wingate Institute,Netanya, Israel; and
e Geriatric Research, Education, and Clinical Center, Division of Geriatric Medicine and Research Institute of Gerontology,University of Michigan, Ann Arbor, MI.
Abstract
Objectives:
To test the effects of a new motor imagery practice approach, in which motor and motivational contents were integrated in order toimprove gait in subjects with chronic poststroke hemiparesis.
Design:
A half-crossover study composed of 2 phases. In phase 1, subjects were randomly assigned to receive either the experimental or thecontrol treatment. In phase 2, the subjects who had initially received the control treatment “crossed over” to receive the experimental intervention.
Setting:
The experimental and the control intervention were delivered in the subjects’ homes; assessments were performed in a hospital laboratory.
Participants:
Community-dwelling individuals (N=23) with chronic post stroke hemiparesis whose gait was impaired.
Interventions:
The experimental intervention, called integrated motor imagery practice, consisted of imagery scripts aimed at improving home and community walking as well as fall-related self efficacy. The control treatment consisted of executed exercises to improve the function of the involved upper extremity.
Main Outcome Measures:
In-home walking, indoor and outdoor community ambulation, and fall-related self efficacy. These were assessed before and after the intervention as well as at a 2-week follow-up.
Results:
In-home walking was significantly improved after application of the experimental intervention (P≤.003), but not after the control treatment (P≤.68). Community ambulation did not improve. Fall-related self efficacy was slightly improved by the integrated motor imagery intervention; however, the findings were not unequivocal.
Conclusions:
Home delivery of integrated motor imagery practice was feasible and exerted a positive effect on walking in the home. However, it was ineffective for improving gait in public domains. We speculate that the addition of physical practice to imagery practice may be essential for achieving that end.Archives of Physical Medicine and Rehabilitation 2013;94:2119-25
ª
2013 by the American Congress of Rehabilitation Medicine
To test the effects of a new motor imagery practice approach, in which motor and motivational contents were integrated in order toimprove gait in subjects with chronic poststroke hemiparesis.
Design:
A half-crossover study composed of 2 phases. In phase 1, subjects were randomly assigned to receive either the experimental or thecontrol treatment. In phase 2, the subjects who had initially received the control treatment “crossed over” to receive the experimental intervention.
Setting:
The experimental and the control intervention were delivered in the subjects’ homes; assessments were performed in a hospital laboratory.
Participants:
Community-dwelling individuals (N=23) with chronic post stroke hemiparesis whose gait was impaired.
Interventions:
The experimental intervention, called integrated motor imagery practice, consisted of imagery scripts aimed at improving home and community walking as well as fall-related self efficacy. The control treatment consisted of executed exercises to improve the function of the involved upper extremity.
Main Outcome Measures:
In-home walking, indoor and outdoor community ambulation, and fall-related self efficacy. These were assessed before and after the intervention as well as at a 2-week follow-up.
Results:
In-home walking was significantly improved after application of the experimental intervention (P≤.003), but not after the control treatment (P≤.68). Community ambulation did not improve. Fall-related self efficacy was slightly improved by the integrated motor imagery intervention; however, the findings were not unequivocal.
Conclusions:
Home delivery of integrated motor imagery practice was feasible and exerted a positive effect on walking in the home. However, it was ineffective for improving gait in public domains. We speculate that the addition of physical practice to imagery practice may be essential for achieving that end.Archives of Physical Medicine and Rehabilitation 2013;94:2119-25
ª
2013 by the American Congress of Rehabilitation Medicine
No comments:
Post a Comment