Effect of Integrated Mental Practice on Post-stroke Gait and Self Efficacy

描述（由申请人提供）：中风患者有大量的长期残疾，特别是在行走方面。运动和动机意象（“综合心理练习”）是一种安全和廉价的锻炼程序，用于提高自我效能和运动表现。拟议研究的目标是实施和测试的结果，综合心理实践干预社区居住的个人中风谁是步行障碍，由于轻偏瘫。PI假设，将这种综合心理练习计划应用于卒中后个体将（1）改善步态速度和社区步行，（2）增强跌倒相关的自我效能。实验干预将包括运动想象练习的流动任务，使用视觉和动觉意象;视觉意象任务将与动机意象策略相结合。随机分组后，将接受四周意象训练的实验组与接受上肢锻炼的对照组进行比较。随后，在两周的间隔之后，对照患者也将接受为期四周的实验性治疗。主要结果将是步行速度，社区步行表现和跌倒功效，在干预前，中期，干预后和两周随访时进行测试。该提案利用了一位以色列研究人员及其团队的专业知识，与经验丰富的美国团队进行了独特而实用的干预。我们的目标是将该计划转移到美国，并最终发展一个更大规模的美国-基于随机对照的RO 1研究，以检查卒中后个体的综合意象训练的结果和机制。 与公共卫生的相关性：中风后的个人通常被限制在家中或在社区中的活动能力有限。步态速度下降以及跌倒相关的自我效能低是这些人不动和生活方式受限的主要原因。一旦个人回到社区，也缺乏康复选择。在这项可行性研究中，PI建议使用基于家庭的运动和动机意象自我练习，以增强自信心，防止恶化，并促进运动和功能能力的恢复。

DESCRIPTION (provided by applicant): Stroke patients have substantial long term disability, particularly in walking. Motor and motivational imagery ("Integrated mental practice") is a safe and inexpensive exercise routine for improving self efficacy and motor performance. The goals of the proposed study are to implement and test the outcomes of an integrated mental practice intervention to community dwelling individuals with stroke who are walking-impaired due to hemiparesis. The PIs hypothesize that the application of this integrated mental practice program to individuals post-stroke will (1) improve gait speed and community walking, and (2) enhance fall related self efficacy. The experimental intervention will be composed of motor imagery practice of ambulatory tasks using both visual and kinesthetic imagery; visual imagery tasks will be coupled with motivational imagery strategies. Following randomization, an experimental group receiving four weeks of imagery training will be compared with controls receiving upper extremity exercises. Subsequently, following a two week interval, the control patients will also receive the four-week experimental treatment. The main outcomes will be walking speed, community walking performance and fall efficacy, tested before the intervention, at midterm, post-intervention, and at two weeks follow-up. This proposal leverages the expertise of an Israeli researcher and her team using a unique and practical intervention with an experienced U.S. team. The goal is to transfer the program to the U.S. and eventually develop a larger scale U.S.-based randomized controlled RO1 study to examine outcomes as well as mechanisms of integrated imagery training for individuals post-stroke. Relevance to Public Health: Individuals post-stroke are often confined to their homes or have only limited mobility in the community. Decreased gait speed as well as low fall-related self efficacy are major causes of immobility and restricted life style in these individuals. There is also a shortage of rehabilitation options once individuals are in their communities. In this feasibility study the PIs propose the use of a home based self practice of motor and motivational imagery to enhance self confidence, prevent deterioration and facilitate the restoration of motor and functional abilities.