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

综合心理练习对中风后步态和自我效能的影响

• 批准号: 7599658
• 负责人: Ruth Dickstein
• 金额: $ 5.4万
• 依托单位: UNIVERSITY OF HAIFA
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-04-01 至 2011-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7599658
• 关键词: Activities of Daily Living; Affect; American; Chronic; Collaborations; Communities; Coupled; Deterioration; Effectiveness; Elderly; Esthesia; Exercise; Family; Feasibility Studies; Gait; Goals; Home environment; Human; Imagery; Impairment; Individual; Intervention; Israel; Knowledge; Life; Life Style; Motivation; Motor; Movement; Neurologic; Outcome; Patients; Performance; Persons; Physical therapy; Process; Psyche structure; Public Health; Randomized; Randomized Controlled Trials; Rehabilitation therapy; Reproduction; Research Personnel; Risk; Scientist; Self Efficacy; Self-Administered; Speed; Sports; Stimulus; Stroke; Testing; Training; Upper Extremity; Visual; Walking; base; community setting; disability; efficacy testing; experience; falls; follow-up; hemiparesis; improved; mental imagery; mental practice; post intervention; post stroke; prevent; programs; restoration; sedentary; visual imagery

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.

描述（由申请人提供）：中风患者有严重的长期残疾，特别是行走方面。运动和动机意象（“综合心理练习”）是一种安全、廉价的日常锻炼，可以提高自我效能和运动表现。本研究的目的是对社区居住的因偏瘫导致行走障碍的脑卒中患者实施和测试综合心理实践干预的结果。PIs假设，将这种综合心理练习项目应用于中风后的个体将(1)改善步态速度和社区步行，(2)增强跌倒相关的自我效能感。实验干预将包括使用视觉和动觉意象的移动任务的运动意象练习；视觉意象任务将与动机意象策略相结合。随机分组后，实验组接受四周的意象训练，对照组接受上肢锻炼。随后，经过两周的间隔，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效果，在干预前、中期、干预后和两周随访时进行测试。该提案利用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一起使用独特而实用的干预措施。目标是将该项目转移到美国，并最终在美国开展更大规模的随机对照RO1研究，以检查中风后个体综合图像训练的结果和机制。