Effect of Training in Visual Motor Imagery to Improve Reaching and Gripping Actions for a Single Subject with Stroke in the Supplementary Motor Area 4344

Abstract

Objectives

To investigate the effect of my rehabilitation using visual motor imagery training on a subject with stroke in the supplementary motor area. The subject had disorders with reaching and gripping actions, cognitive decline, and attention deficit.

Design

This report is a single case intervention study of before-after trial of my rehabilitation.

Setting

The setting is hospitalized acute phase rehabilitation for a single subject. The study was approved by the local ethics committee and conducted in accordance with the Declaration of Helsinki. The patient gave written, informed consent.

Participants

The study was a 70-year-old subject with stroke on the right side of the supplementary motor area. The disease caused the subject to have a disability in reaching and gripping actions. Also, the subject had symptoms of cognitive decline and attention deficit. The physical finding was Fugl-Meyer Assessment upper extremity on the left side (10/66). The neuropsychologic findings were Raven's Colored Progressive Matrices (20), Token Test (15), Trail Making Test (impossible).

Interventions

The intervention was visual motor imagery training for the subject 1 time a day for 40 minutes per day, 5 days, for a period of 3 weeks. The motor imagery training consisted of 2 steps. Firstly, the subject was shown 3 videos, which showed motor actions of the hand grasping, hand rotation, and reaching and gripping a ball. These videos also showed the therapist's own hand movements. During this process, the subject mentally rehearsed these actions without overt movement. After this, the subject attempted to execute these motor actions physically.

Main Outcome Measures

The subject's upper limb function was evaluated as follows: reaching and gripping action times to a ball which was held at 40 cm in front of the subject (30.31s), reaching and gripping action times to a cup (impossible), and reaching and gripping action times to a bowl (impossible).

Results

These reaching and gripping actions were changed after my rehabilitation period of 3 weeks. The reaching and gripping action times to a ball (5.11s), the reaching and gripping action times to a cup (9.89s), and reaching and gripping action times to a bowl (7.82s).

Conclusions

Visual Motor imagery training had a positive effect on the single subject with supplementary motor area stroke to improve the reaching and gripping actions, although the subject had cognitive decline and attention deficit.

Disclosures

none.