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Ther Adv Neurol Disord. 2018 Oct 9;11:1756286418804785. doi: 10.1177/1756286418804785. eCollection 2018.

Effect of the combination of motor imagery and electrical stimulation on upper extremity motor function in patients with chronic stroke: preliminary results.

Author information

1
Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan.
2
Department of Rehabilitation Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
3
Department of Rehabilitation Medicine, Keio University Hospital, Tokyo, Japan.
4
Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake-shi, Aichi, Japan.
5
Department of Physical Therapy, Yamagata Prefectural University of Health Sciences, Yamagata-shi, Yamagata, Japan.

Abstract

Background:

The combination of motor imagery (MI) and afferent input with electrical stimulation (ES) enhances the excitability of the corticospinal tract compared with motor imagery alone or electrical stimulation alone. However, its therapeutic effect is unknown in patients with hemiparetic stroke. We performed a preliminary examination of the therapeutic effects of MI + ES on upper extremity (UE) motor function in patients with chronic stroke.

Methods:

A total of 10 patients with chronic stroke demonstrating severe hemiparesis participated. The imagined task was extension of the affected finger. Peripheral nerve electrical stimulation was applied to the radial nerve at the spiral groove. MI + ES intervention was conducted for 10 days. UE motor function as assessed with the Fugl-Meyer assessment UE motor score (FMA-UE), the amount of the affected UE use in daily life as assessed with a Motor Activity Log (MAL-AOU), and the degree of hypertonia in flexor muscles as assessed with the Modified Ashworth Scale (MAS) were evaluated before and after intervention. To assess the change in spinal neural circuits, reciprocal inhibition between forearm extensor and flexor muscles with the H reflex conditioning-test paradigm at interstimulus intervals (ISIs) of 0, 20, and 100 ms were measured before and after intervention.

Results:

UE motor function, the amount of the affected UE use, and muscle hypertonia in flexor muscles were significantly improved after MI + ES intervention (FMA-UE: p < 0.01, MAL-AOU: p < 0.01, MAS: p = 0.02). Neurophysiologically, the intervention induced restoration of reciprocal inhibition from the forearm extensor to the flexor muscles (ISI at 0 ms: p = 0.03, ISI at 20 ms: p = 0.03, ISI at 100 ms: p = 0.01).

Conclusion:

MI + ES intervention was effective for improving UE motor function in patients with severe paralysis.

KEYWORDS:

cerebrovascular disease; electrical stimulation; hemiparesis; motor imagery; rehabilitation

Conflict of interest statement

Conflict of interest statement: The authors declare that there is no conflict of interest.

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