Effects of home-based motor imagery training on upper extremity function in chronic stroke patients: a randomized and controlled trial

Abstract

Objective To investigate the effect of home-based motor imagery training on the lower extremity motor function,balance ability and activities of daily living in post-stroke patients. Methods Fifty-six stroke survivors were divided into the control group and the intervention group by random number table method.All the patients got the conventional nursing, rehabilitation booklets and the video tapes which contained physical therapy and occupational therapy. Furthermore, the patients in the intervention group received 6 weeks motor imagery (MI) therapy through an instant messaging client (Tencent QQ), three times a week, 30mins per time. The outcomes were measured before discharge (T0), immediately after the intervention (T1), and 6 weeks (T2) after the intervention using the Fugl-Meyer Motor Assessment Scale(FMA), Berg Balance Scale (BBS), Barthel Index (BI). Results At baseline, the scores of FMA、BBS、BI in the intervention group were (15.12±4.19), (24.50±2.72), (54.04±17.44) points, while in the control group were (14.23±3.67), (23.92±2.82), (49.46±15.09) points. There were no differences on any scale between the two groups at baseline (t=0.810, 0.750, 1.012, P > 0.05). At 6 weeks,the scores of FMA, BB, BI in the control group were (14.81±3.50), (29.31±2.43), (50.77±14.47) points, and were significantly lower than (17.38±4.10), (37.38±4.30), (74.62±11.22) pointsin the interventiongroup (t=2.438, 8.326,6.641, P < 0.05 or 0.01). At 12 weeks, the scores of FMA, BB, BI in the control group were (15.54±3.44), (32.35±1.98), (59.08±13.85) points, and were significantly lower than (18.58±4.19), (41.19±3.96), (86.54±9.88) points in the intervention group (t=2.858, 10.189, 8.233, P < 0.01). A main effect of intervention (F=4.158, 63.716, 30.379, P < 0.05) and an interactive effect of time and intervention (F=47.941, 61.029,29.685, P=0.000) were observed in the model of FMA, BBS, BI using ANOVA of repeated measures. The factors were compared with each other and the difference was statistically significant (P=0.000). Conclusions The home-based MI training can improve the lower extremity motor function, balance ability and activities of daily living in patients with stroke. Key words: Stroke; Rehabilitation nursing; Tele rehabilitation; Motor imagery