Could motor imagery be effective in upper limb rehabilitation of individuals with spinal cord injury? A case study

Abstract

Study design: A case study. Objective: The aim was to investigate whether motor imagery (MI) could be successfully incorporated into conventional therapy among individuals with spinal cord injury (SCI) to improve upper limb (UL) function. Setting: The Physical Medicine and Rehabilitation Unit at the Henry Gabrielle Hospital in Lyon, France. Methods: The participant was an individual with a complete C6 SCI. MI content was focused on functional UL movements, to improve hand transport to reach out and grasp with tenodesis. The participant was tested before and after 15 MI training sessions (45 min each, three times a week during 5 consecutive weeks). MI ability and program compliance were used as indicators of feasibility. The Minnesota and Box and Blocks tests, as well as movement time and hand trajectory during targeted movements were the dependent variables, evaluating motor performance before and after MI training. Results: The participant's ability to generate MI was checked and compliance with the rehabilitation program was confirmed. The time needed to complete the Minnesota test decreased by 1 min 25 s. The Box and Blocks score was improved by three units after MI program. Decreased movement time and enhanced hand trajectory smoothness were still observed 3 months later, despite a slight decrease in performance. Conclusions: This study supports the feasibility for introducing MI in conventional therapy. Further studies should confirm the potential role of MI in motor recovery with a larger sample.

Neuroplasticity of imagined wrist actions after spinal cord injury: a pilot study

“…MV was reduced in three SCI participants (≈70 %), whereas 81 % of increase was measured in one SCI subject. While we only focused on the tenodesis grasp, Grangeon et al (2012) reported reduced variability of hand trajectories during point-to-grasp actions after 5 weeks of rehabilitation with MI. Here, the baseline period was of equivalent duration to the intervention period in SCI participants with stabilized motor deficits.…”

“…This was not expected for SCI subjects. MI training has been shown to improve movement speed during tenodesis actions, yet in single-case experimental designs (Grangeon et al 2012). Greater sample size in the present design should have enabled to detect meaningful effects.…”

“…SCI subjects also appeared to benefit from MI training programs to learn motor sequences executed with intact muscles (Cramer et al 2007). In clinical settings, single-case pilot experiments yielded that MI practice could improve the tenodesis prehension, i.e., increased movement speed and smoother hand trajectories were reported (Grangeon et al 2012(Grangeon et al , 2010. The authors inferred an effect of the technique on brain neuroplasticity, which was recently evidenced using magnetoencephalography (MEG) (Di Rienzo et al 2014b).…”

Interfaz cerebro-computador multimodal para procesos de neurorrehabilitación de miembros superiores en pacientes con lesiones de médula espinal: una revisión

“…Adaptada de [32] Una de las grandes inquietudes que surge es si en efecto un proceso de rehabilitación apoyado con BCI invasiva puede restaurar funciones motoras. Al respecto, en un caso de estudio realizado en el año 2011 [8] se reporta que un paciente con lesión en C6 logró reducir el tiempo de realización del Test de Minnesota de destreza manual en 1 min y 25 s, demostrándose así que las BCI de imaginación motora pueden ser introducidas en procesos convencionales de rehabilitación a nivel de miembros superiores en pacientes con lesiones medulares. Recientemente, en un reporte científico en la revista Neurosurgery [3] se mostró el efecto de las BCI en procesos de rehabilitación física después de 12 meses de continuo trabajo con ocho pacientes con paraplejía completa, de los cuales 4 pacientes fueron posteriormente diagnosticados con paraplejía incompleta.…”

Effects of a standard transfer exercise program on transfer quality and activities of daily living for transfer-dependent spinal cord injury patients

“…The validity of motor imagery has been proven in numerous studies which have investigated this technique and its neurophysiological basis in patients with spinal cord injuries5,6,7,8,9,10,11 ) . Grangeon et al10 ) showed that motor image training and general rehabilitation training in cervical injury patients improved their score in the performance of hand function tasks and also shortened performance time, thus demonstrating that motor image treatment and general rehabilitation treatment are effective when conducted together. However, because study of Grangeon et al10 ) has been conducted case study of cervical patients, it is a difficult to generalize.…”