Mental Imagery to reduce motor impairments in stroke

描述（由申请人提供）：许多卒中幸存者的运动能力有限，生活质量受损。旨在增强运动功能和促进中风后受损上肢独立使用的治疗干预措施有限。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际的、基于证据的治疗干预措施。一种技术，约束诱导疗法（CIT），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，补充治疗，心理练习，可以提高运动技能的表现。研究人员建议在身体康复中使用心理练习作为一种具有成本效益的手段，以促进中枢神经系统受损后的运动恢复。本研究的主要目的是收集数据，以评估实施一种形式的CIT，重复任务练习（RTP）结合心理意象训练（MIT），以改善慢性卒中患者的上肢运动功能和生活质量的临床有效性。因此，我们假设，心理意象的运动任务结合RTP可能会导致减少上肢（UE）的损害和改善UE功能的结果相比，RTP单独，和共同的神经结构可以使用功能磁共振成像进行调查。具体目标将力求估计：1）RTP联合MIT对脑卒中患者运动功能恢复的有效性，2）RTP与MIT联合使用对卒中患者健康相关生活质量的有效性，以及3）在执行特定任务期间皮质激活图组织变化之间的关联（执行的与想象的手指屈曲-伸展序列）和接受RTP + MIT时中风患者的临床运动功能与单独MIT相比的改善。

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.