Effect of Motor Imaginary Training on Upper Limb Functions in Stroke

This study will provide knowledge about effectiveness of motor imaginary training in upper limb performance in chronic stroke patients. Very little data is available about the use in Motor Imaginary in post stroke upper limb rehabilitation in Pakistan. Moreover, studies done previously did not specified population of stroke; This study will include MCA stroke patients only, whom upper limb weakness is more prevalent.

Motor imagery is a technique for inducing motor activity in response to a certain motor output by producing a mental image of the action without intending to conduct it. It is a cognitive technique that, rather than making a patient to pick up new procedures, promotes neural alterations in order enable the patient to re-acquire motor skills mastered before the CVA or copy the actions of others. Motor imaging training is a sort of therapy in which the patient imagines a gesture or movement in order to learn, reinforce, or improve the movement's performance. A study done in South Korea, published in 2015, revealed that Motor imagery training has a good impact on UL performance by refining functional mobility during stroke rehabilitation. The results suggest that motor imagery training is viable and helpful for improving UL function in CVA patients. Meta-analysis done in Australia in the year 2013, was supportive of Motor imaginary techniques further convincing that Mental imagery can be a possible intervention for stroke patients given that it being, safe cost-effective & unlimited practice opportunities. Study done in China in 2017, suggested that clinicians should consider the use of MI in addition to treatment currently used to improve upper extremity functions after stroke as no evidence of side effects or harm was noted . RCT done in year 2006 in USA indicated that for patients with chronic, moderate upper limb impairment after CVA, program of CIMT with mental practice only resulted in decrease impairment, with functional enhancement.

The Wolf Motor Function Test (WMFT) is a timed and functional test that assesses upper extremity motor skills in a quantitative manner.

Inclusion Criteria: MCA stroke Chronic stroke patients Mini-Mental State Examination (MMSE) score >24 points Spasticity grade II and III on Modified Ashworth scale Exclusion Criteria: Severe cognitive disability such as depression, unilateral neglect, seizure, dementia, Any MSK disorder including muscle contracture