Exploring the impact of visual and movement based priming on a motor intervention in the acute phase post-stroke in persons with severe hemiparesis of the upper extremity

Abstract

Purpose Explore the potential benefits of using priming methods prior to an active hand task in the acute phase post-stroke in persons with severe upper extremity hemiparesis. Methods Five individuals were trained using priming techniques including virtual reality (VR) based visual mirror feedback and contralaterally controlled passive movement strategies prior to training with an active pinch force modulation task. Clinical, kinetic, and neurophysiological measurements were taken pre and post the training period. Clinical measures were taken at six months post training. Results The two priming simulations and active training were well tolerated early after stroke. Priming effects were suggested by increased maximal pinch force immediately after visual and movement based priming. Despite having no clinically observable movement distally, the subjects were able to volitionally coordinate isometric force and muscle activity (EMG) in a pinch tracing task. The Root Mean Square Error (RMSE) of force during the pinch trace task gradually decreased over the training period suggesting learning may have occurred. Changes in motor cortical neurophysiology were seen in the unaffected hemisphere using Transcranial Magnetic Stimulation (TMS) mapping. Significant improvements in motor recovery as measured by the Action Research Arm Test (ARAT) and the Upper Extremity Fugl Meyer Assessment (UEFMA) were demonstrated at six months post training by three of the five subjects. Conclusion This study suggests that an early hand-based intervention using visual and movement based priming activities and a scaled motor task allows participation by persons without the motor control required for traditionally presented rehabilitation and testing.

Mirror Therapy Improved Muscle Strength of the Elderly

“…However, muscle strength in the intervention group after the intervention experienced a significant increase and in the control group it decreased significantly after the intervention. These results are in accordance with the research by [6], [7], [8], [9], [10], [11]. Physiologically elderly will experience muscle weakness so it hinders the fulfillment of daily activities and even prone to injury.…”

“…There were differences in the mean of muscle strength scale before and after the intervention in the intervention and control groups. The results of this study are in line with previous studies conducted by by [6], [7], [8], [9], [10], [11]. There are differences in mirror therapy and gymnastic nursing interventions given to the elderly.…”

“…There is a significant effect of mirror therapy on increasing muscle strength in the elderly. The results of this study are supported by previous studies conducted by [6], [7], [8]; [9] on stroke clients, [10] on adult clients, and [11] in post-stroke clients. The results of the study mentioned that miror therapy was significantly able to increase the functional abilities of the extremities.…”

“…This therapy focuses on motor visualization where the mirror as a medium will provide visual stimulation to the body experiencing muscle weakness from healthy body parts [6]. [11] mentions that the elderly will imagine to activate cerebral, ipsilateral, contralateral motor nerves. From the results of this activation leads the movement of limbs that experience muscle weakness through observation of the movement of other healthy limbs.…”

“…The movement series of this activities consist of fingers' extention-flexion, also making and releasing a fist [6]. Several sudies have been done, one of them was by [7], [8], [9] in stroke patients, [10] in adult patients, lastly by [11] in post-stroke patients. The studies stated that mirror therapy significantly increase movement ability of the exremities.…”