Mental Imagery to reduce motor impairments in stroke

描述（由申请人提供）：许多中风幸存者在运动能力和生活质量方面受到限制。旨在增强运动功能和促进中风后上肢独立使用的治疗干预措施是有限的。有必要将对神经系统可塑性有影响的独特行为和认知技术转化为实用的、循证的治疗干预措施。一种技术，约束诱导疗法（CIT），已经产生的结果可以大大减少许多中风患者的失能缺陷，并可以提高他们的独立性。最近的研究表明，一种辅助治疗，即心理练习，可以提高运动技能的表现。研究人员提出在身体康复中使用心理练习，作为促进中枢神经系统损伤后运动恢复的一种经济有效的手段。本研究的主要目的是收集数据，以评估实施CIT的一种形式，即重复性任务练习（RTP）结合心理意象训练（MIT）改善慢性卒中患者上肢运动功能和生活质量的临床效果。因此，我们假设，与RTP单独相比，运动任务的心理意象结合RTP可能导致上肢（UE）损伤的减少和UE功能的改善，并且可以使用fMRI研究常见的神经结构。具体目标将设法估计：1) RTP联合MIT对脑卒中患者运动恢复的效果；2) RTP联合MIT对脑卒中患者健康相关生活质量的影响；3)与单独MIT相比，接受RTP + MIT的脑卒中患者在执行特定任务（执行与想象手指屈伸序列）时皮质激活图谱的组织变化与临床运动功能改善之间的关系。

DESCRIPTION (provided by applicant): Many stroke survivors have limitations in motor ability and compromised quality of life. Therapeutic interventions designed to enhance motor function and promote independent use of an impaired upper extremity following stroke are limited. There is a need to translate unique behavioral and cognitive techniques shown to have an impact on plasticity in the nervous system into practical, evidence-based, therapeutic interventions. One technique, constraint induced therapy (CIT), has produced results that can substantially reduce the incapacitating deficits of many patients with stroke and can increase their independence. Recent studies have shown that a complementary treatment, mental practice, can improve the performance of motor skills. Investigators have proposed the use of mental practice in physical rehabilitation as a cost-efficient means to promote motor recovery after damage to the central nervous system. The primary purpose of the proposed study is to collect data in an effort to estimate the clinical effectiveness of implementing one form of CIT, repetitive task practice (RTP) in conjunction with mental imagery training (MIT) to improve upper extremity motor function and quality of life of chronic stroke patients. Therefore, we hypothesize that mental imagery of a motor task combined with RTP may lead to decreased upper extremity (UE) impairment and improved UE functional outcome compared to RTP alone, and that common neural structures can be investigated using fMRI. Specific aims will seek to estimate: 1) the effectiveness of using RTP in conjunction with MIT on motor recovery of patients with stroke, 2) the effectiveness of using RTP in conjunction with MIT on health related quality of life of patients with stroke and 3) the association between changes in the organization of cortical activation maps during the performance of a specific task (executed vs. imagined finger flexion-extension sequence) and improvement in clinical motor function of patients with stroke when receiving RTP + MIT compared to MIT alone.