Comparisons between modified constraint-induced movement therapy (mCIMT) and a combined therapy of mental practice and mCIMT in persons with stroke

Abstract

This study aimed to compare the effect of combined therapy of mental practice (MP) and modified Constraint-induced Movement Therapy (mCIMT) with mCIMT alone on hemiplegic stroke patients.The subjects of this study were fourteen people who have had a stroke and they were divided into two groups of experimental (n=7) and control group (n=7) using stratified randomization. Motor evoked potential was used to measure the corticospinal excitability, 3D motion analysis to examine the quality of movement, Jebsen-Taylor hand function test to evaluate the functional quality, and Motor Ativity Log(MAL) to evaluate the changes in activities of daily living(ADL). All participants participated in 2-week of mCIMT intervention and only the experimental group partook in additional ten minutes of mental practice.As a result, when applied the combined therapy of mental practice and mCIMT and mCIMT alone, both group significantly improved in the movement quality of reaching and performance level in daily lives (p <.05). However, in the experimental group receiving the combined therapy of mental practice and mCIMT, functional improvement of upper limb additionally took place (p <.05). Also, the improvement of corticospinal excitability, upper extremity function, and performance in ADL was significantly greater in the experimental group as compared to the control group (p <.05). Further, when measured the corticospinal excitability in four conditions of rest and mental practice at pre- and post-intervention test of the experimental group, the gradual increase in corticospinal excitability was statistically significant (p <.05).This study confirmed that the combined therapy of mental practice and mCIMT makes more effective improvement than mCIMT alone in corticospinal excitability, upper limb function, and ADL. Therefore, the combined therapy of mental practice and mCIMT could be used as a clinically useful intervention.