Comments on "Effectiveness of Motor Imagery Combined with Structured Progressive Circuit Class Training on Functional Mobility in Post-Stroke Individuals".
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SUBMITTER: Nakashima Y
PROVIDER: S-EPMC9593483 | biostudies-literature | 2022 Oct
REPOSITORIES: biostudies-literature
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Comments on "Effectiveness of Motor Imagery Combined with Structured Progressive Circuit Class Training on Functional Mobility in Post-Stroke Individuals".
Nakashima Yuki Y Iwasaki Keisuke K Taito Shunsuke S
Journal of rehabilitation medicine 20221018
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Project description:ObjectiveTo compare the effect of motor imagery combined with structured progressive circuit class therapy vs health education combined with structured progressive circuit class therapy on dynamic balance, endurance, and functional mobility in post-stroke individuals.DesignRandomized controlled trial.MethodsA total of 40 post-stroke individuals were randomly assigned to experimental and control groups. The experimental group was trained using motor imagery combined with structured progressive circuit class therapy, while the control group received health education combined with structured progressive circuit class therapy, 3 times a week for 4 weeks with an overall of 12 sessions. Outcomes included the step test for affected and unaffected limbs, the 6-Minute Walk Test, and the Timed Up and Go test. Assessments were performed at baseline, 2 weeks, and 4 weeks after the intervention Results: There were significant effects (p < 0.05) of: group on the step test for unaffected limb; of time on all outcomes; and of their interaction effect on the step test for affected limb, 6-Minute Walk Test, and Timed Up and Go test. Inter-group comparison showed significant differences (p < 0.05) in the step test for unaffected limb at 2 weeks after the intervention. At 4 weeks after the intervention, significant differences (p < 0.05) were found in the step test for affected and unaffected limbs and in the Timed Up and Go test.ConclusionMotor imagery combined with structured progressive circuit class therapy was more effective on the step test, 6-Minute Walk Test, and Timed Up and Go test than training with structured progressive circuit class therapy alone. This suggest that that motor imagery should be incorporated into training programmes for restoring dynamic balance, endurance, and functional mobility in post-stroke individuals.
| S-EPMC9422877 | biostudies-literature
Project description:Structured Progressive Circuit Class Therapy (SPCCT) was developed based on task-oriented therapy, providing benefits to patients' motivation and motor function. Training with Motor Imagery (MI) alone can improve gait performance in stroke survivors, but a greater effect may be observed when combined with SPCCT. Health education (HE) is a basic component of stroke rehabilitation and can reduce depression and emotional distress. Thus, this study aimed to investigate the effect of MI with SPCCT against HE with SPCCT on gait in stroke survivors. Two hundred and ninety stroke survivors from 3 hospitals in Yangon, Myanmar enrolled in the study. Of these, 40 stroke survivors who passed the selection criteria were randomized into an experimental (n?=?20) or control (n?=?20) group. The experimental group received MI training whereas the control group received HE for 25?minutes prior to having the same 65?minutes SPCCT program, with both groups receiving training 3 times a week over 4 weeks. Temporo-spatial gait variables and lower limb muscle strength of the affected side were assessed at baseline, 2 weeks, and 4 weeks after intervention. After 4 weeks of training, the experimental group showed greater improvement than the control group in all temporospatial gait variables, except for the unaffected step length and step time symmetry which showed no difference. In addition, greater improvements of the affected hip flexor and knee extensor muscle strength were found in the experimental group. In conclusion, a combination of MI with SPCCT provided a greater therapeutic effect on gait and lower limb muscle strengths in stroke survivors.
| S-EPMC7181781 | biostudies-literature
Project description:This paper presents a gamified motor imagery brain-computer interface (MI-BCI) training in immersive virtual reality. The aim of the proposed training method is to increase engagement, attention, and motivation in co-adaptive event-driven MI-BCI training. This was achieved using gamification, progressive increase of the training pace, and virtual reality design reinforcing body ownership transfer (embodiment) into the avatar. From the 20 healthy participants performing 6 runs of 2-class MI-BCI training (left/right hand), 19 were trained for a basic level of MI-BCI operation, with average peak accuracy in the session = 75.84%. This confirms the proposed training method succeeded in improvement of the MI-BCI skills; moreover, participants were leaving the session in high positive affect. Although the performance was not directly correlated to the degree of embodiment, subjective magnitude of the body ownership transfer illusion correlated with the ability to modulate the sensorimotor rhythm.
| S-EPMC6775193 | biostudies-literature
Project description:Motor imagery (MI) is the mental simulation of action frequently used by professionals in different fields. However, with respect to performance, well-controlled functional imaging studies on MI training are sparse. We investigated changes in fMRI representation going along with performance changes of a finger sequence (error and velocity) after MI training in 48 healthy young volunteers. Before training, we tested the vividness of kinesthetic and visual imagery. During tests, participants were instructed to move or to imagine moving the fingers of the right hand in a specific order. During MI training, participants repeatedly imagined the sequence for 15 min. Imaging analysis was performed using a full-factorial design to assess brain changes due to imagery training. We also used regression analyses to identify those who profited from training (performance outcome and gain) with initial imagery scores (vividness) and fMRI activation magnitude during MI at pre-test (MIpre ). After training, error rate decreased and velocity increased. We combined both parameters into a common performance index. FMRI activation in the left inferior parietal lobe (IPL) was associated with MI and increased over time. In addition, fMRI activation in the right IPL during MIpre was associated with high initial kinesthetic vividness. High kinesthetic imagery vividness predicted a high performance after training. In contrast, occipital activation, associated with visual imagery strategies, showed a negative predictive value for performance. Our data echo the importance of high kinesthetic vividness for MI training outcome and consider IPL as a key area during MI and through MI training.
| S-EPMC6866530 | biostudies-literature
Project description:The aim was to compare the effectiveness of dual-task training (DTT) compared to single mobility training (SMT) on dual-task walking, mobility and cognition, in persons with Multiple Sclerosis (pwMS). Forty pwMS were randomly assigned to the DTT or SMT groups. The DTT-group performed dual-task exercises using an interactive tablet-based application, while the SMT-group received conventional walking and balance exercises. Both interventions were supervised and identical in weeks (8) and sessions (20). Nine cognitive-motor dual-task conditions were assessed at baseline, after intervention and at 4-weeks follow-up (FU). The dual-task cost (DTC), percentage change of dual-task performance compared to single-task performance, was the primary outcome. Mobility and cognition were secondarily assessed. Mixed model analyses were done with group, time and the interaction between group and time as fixed factors and participants as random factors. Significant time by group interactions were found for the digit-span walk and subtraction walk dual-task conditions, with a reduction in DTC (gait speed) for the DTT maintained at FU. Further, absolute dual-task gait speed during walking over obstacles only improved after the DTT. Significant improvements were found for both groups in various motor and cognitive measures. However, the DTT led to better dual-task walking compared to the SMT.
| S-EPMC6947084 | biostudies-literature
Project description:BackgroundBoth motor imagery (MI) and motor execution (ME) can facilitate motor cortical excitability. Although cortical excitability is modulated by intracortical inhibitory and excitatory circuits in the human primary motor cortex, it is not clear which intracortical circuits determine the differences in corticospinal excitability between ME and MI.MethodsWe recruited 10 young healthy subjects aged 18-28 years (mean age: 22.1 ± 3.14 years; five women and five men) for this study. The experiment consisted of two sets of tasks involving grasp actions of the right hand: imagining and executing them. Corticospinal excitability and short-interval intracortical inhibition (SICI) were measured before the interventional protocol using transcranial magnetic stimulation (baseline), as well as at 0, 20, and 40 min (T0, T20, and T40) thereafter.ResultsFacilitation of corticospinal excitability was significantly greater after ME than after MI in the right abductor pollicis brevis (APB) at T0 and T20 (p < 0.01 for T0, and p < 0.05 for T20), but not in the first dorsal interosseous (FDI) muscle. On the other hand, no significant differences in SICI between ME and MI were found in the APB and FDI muscles. The facilitation of corticospinal excitability at T20 after MI correlated with the Movement Imagery Questionnaire (MIQ) scores for kinesthetic items (Rho = -0.646, p = 0.044) but did not correlate with the MIQ scores for visual items (Rho = -0.265, p = 0.458).DiscussionThe present results revealed significant differences between ME and MI on intracortical excitatory circuits of the human motor cortex, suggesting that cortical excitability differences between ME and MI may be attributed to the activation differences of the excitatory circuits in the primary motor cortex.
| S-EPMC6118197 | biostudies-literature
Project description:ObjectiveReal-time functional magnetic resonance imaging (rt-fMRI) neurofeedback (NF) uses feedback of the patient's own brain activity to self-regulate brain networks which in turn could lead to a change in behavior and clinical symptoms. The objective was to determine the effect of NF and motor training (MOT) alone on motor and non-motor functions in Parkinson's Disease (PD) in a 10-week small Phase I randomized controlled trial.MethodsThirty patients with Parkinson's disease (PD; Hoehn and Yahr I-III) and no significant comorbidity took part in the trial with random allocation to two groups. Group 1 (NF: 15 patients) received rt-fMRI-NF with MOT. Group 2 (MOT: 15 patients) received MOT alone. The primary outcome measure was the Movement Disorder Society-Unified PD Rating Scale-Motor scale (MDS-UPDRS-MS), administered pre- and post-intervention "off-medication". The secondary outcome measures were the "on-medication" MDS-UPDRS, the PD Questionnaire-39, and quantitative motor assessments after 4 and 10 weeks.ResultsPatients in the NF group were able to upregulate activity in the supplementary motor area (SMA) by using motor imagery. They improved by an average of 4.5 points on the MDS-UPDRS-MS in the "off-medication" state (95% confidence interval: -2.5 to -6.6), whereas the MOT group improved only by 1.9 points (95% confidence interval +3.2 to -6.8). The improvement in the intervention group meets the minimal clinically important difference which is also on par with other non-invasive therapies such as repetitive Transcranial Magnetic Stimulation (rTMS). However, the improvement did not differ significantly between the groups. No adverse events were reported in either group.InterpretationThis Phase I study suggests that NF combined with MOT is safe and improves motor symptoms immediately after treatment, but larger trials are needed to explore its superiority over active control conditions.
| S-EPMC4896907 | biostudies-literature
Project description:The objective of this study was to evaluate the effect of Motor Imagery (MI) training on language comprehension. In line with literature suggesting an intimate relationship between the language and the motor system, we proposed that a MI-training could improve language comprehension by facilitating lexico-semantic access. In two experiments, participants were assigned to a kinesthetic motor-imagery training (KMI) group, in which they had to imagine making upper-limb movements, or to a static visual imagery training (SVI) group, in which they had to mentally visualize pictures of landscapes. Differential impacts of both training protocols on two different language comprehension tasks (i.e., semantic categorization and sentence-picture matching task) were investigated. Experiment 1 showed that KMI training can induce better performance (shorter reaction times) than SVI training for the two language comprehension tasks, thus suggesting that a KMI-based motor activation can facilitate lexico-semantic access after only one training session. Experiment 2 aimed at replicating these results using a pre/post-training language assessment and a longer training period (four training sessions spread over four days). Although the improvement magnitude between pre- and post-training sessions was greater in the KMI group than in the SVI one on the semantic categorization task, the sentence-picture matching task tended to provide an opposite pattern of results. Overall, this series of experiments highlights for the first time that motor imagery can contribute to the improvement of lexical-semantic processing and could open new avenues on rehabilitation methods for language deficits.
| S-EPMC9232155 | biostudies-literature
Project description:BackgroundParkinson's disease (PD) causes difficulty with maintaining the speed, size, and vigor of movements, especially when they are internally generated. We previously proposed that the insula is important in motivating intentional movement via its connections with the dorsomedial frontal cortex (dmFC). We demonstrated that subjects with PD can increase the right insula-dmFC functional connectivity using fMRI-based neurofeedback (NF) combined with kinesthetic motor imagery (MI). The current study is a randomized clinical trial testing whether NF-guided kinesthetic MI training can improve motor performance and increase task-based and resting-state right insula-dmFC functional connectivity in subjects with PD.MethodsWe assigned nondemented subjects with mild PD (Hoehn & Yahr stage ≤ 3) to the experimental kinesthetic MI with NF (MI-NF, n = 22) and active control visual imagery (VI, n = 22) groups. Only the MI-NF group received NF-guided MI training (10-12 runs). The NF signal was based on the right insula-dmFC functional connectivity strength. All subjects also practiced their respective imagery tasks at home daily for 4 weeks. Post-training changes in 1) task-based and resting-state right insula-dmFC functional connectivity were the primary imaging outcomes, and 2) MDS-UPDRS motor exam and motor function scores were the primary and secondary clinical outcomes, respectively.ResultsThe MI-NF group was not significantly different from the VI group in any of the primary imaging or clinical outcome measures. The MI-NF group reported subjective improvement in kinesthetic body awareness. There was significant and comparable improvement only in motor function scores in both groups (secondary clinical outcome). This improvement correlated with NF regulation of the right insula-dmFC functional connectivity only in the MI-NF group. Both groups showed specific training effects in whole-brain functional connectivity with distinct neural circuits supporting kinesthetic motor and visual imagery (exploratory imaging outcome).ConclusionsThe functional connectivity-based NF regulation was unsuccessful, however, both kinesthetic MI and VI practice improved motor function in our cohort with mild PD.
| S-EPMC8897714 | biostudies-literature
Project description:Motor imagery, defined as the mental representation of an action without movement-related sensory inputs, is a well-known intervention to improve motor performance. In the current study, we tested whether use-dependent plasticity, a mechanism underlying motor learning, could be induced by an acute session of motor imagery. By means of transcranial magnetic stimulation (TMS) over the left primary motor cortex, we evoked isolated thumb movements in the right hand and assessed corticospinal excitability in the flexor and extensor pollicis brevis muscles. We measured the mean TMS-induced movement direction before and after an acute session of motor imagery practice. In a first experiment, participants of the imagery group were instructed to repeatedly imagine their thumb moving in a direction deviated by 90° from the pre-test movement. This group, but not the control group, deviated the post-training TMS-induced movements toward the training target direction (+44° ± 62° and -1° ± 23°, respectively). Interestingly, the deviation magnitude was driven by the corticospinal excitability increase in the agonist muscle. In a second experiment, we found that post-training TMS-induced movements were proportionally deviated toward the trained direction and returned to baseline 30 minutes after the motor imagery training. These findings suggest that motor imagery induces use-dependent plasticity and, this neural process is accompanied by corticospinal excitability increase in the agonist muscle.
| S-EPMC6934610 | biostudies-literature