Observation and execution of upper-limb movements as a tool for rehabilitation of motor deficits in paretic stroke patients: protocol of a randomized clinical trialReportar como inadecuado




Observation and execution of upper-limb movements as a tool for rehabilitation of motor deficits in paretic stroke patients: protocol of a randomized clinical trial - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

BMC Neurology

, 12:42

First Online: 18 June 2012Received: 28 November 2011Accepted: 18 June 2012

Abstract

BackgroundEvidence exist that motor observation activates the same cortical motor areas that are involved in the performance of the observed actions. The so called -mirror neuron system- has been proposed to be responsible for this phenomenon. We employ this neural system and its capability to re-enact stored motor representations as a tool for rehabilitating motor control. In our new neurorehabilitative schema videotherapy we combine observation of daily actions with concomitant physical training of the observed actions focusing on the upper limbs. Following a pilot study in chronic patients in an ambulatory setting, we currently designed a new multicenter clinical study dedicated to patients in the sub-acute state after stroke using a home-based self-induced training. Within our protocol we assess 1 the capability of action observation to elicit rehabilitational effects in the motor system, and 2 the capacity of this schema to be performed by patients without assistance from a physiotherapist. The results of this study would be of high health and economical relevance.

Methods-designA controlled, randomized, multicenter, paralleled, 6 month follow-up study will be conducted on three groups of patients: one group will be given the experimental treatment whereas the other two will participate in control treatments. All patients will undergo their usual rehabilitative treatment beside participation in the study. The experimental condition consists in the observation and immediate imitation of common daily hand and arm actions. The two parallel control groups are a placebo group and a group receiving usual rehabilitation without any trial-related treatment. Trial randomization is provided via external data management. The primary efficacy endpoint is the improvement of the experimental group in a standardized motor function test Wolf Motor Function Test relative to control groups. Further assessments refer to subjective and qualitative rehabilitational scores. This study has been reviewed and approved by the ethics committee of Aachen University.

DiscussionThis therapy provides an extension of therapeutic procedures for recovery after stroke and emphasizes the importance of action perception in neurorehabilitation The results of the study could become implemented into the wide physiotherapeutic practice, for example as an ad on and individualized therapy.

AbbreviationsANTAlbert’s Neglect Test

BBTBox and Block Test

BDIBeck Depression Inventory

BIBarthel-Index

CRFCase report form

DVDDigital versatile Disc

DSMBData and Safety Monitoring Board

EHIEdinburgh Handedness Inventory

FASTFlorida Apraxia Screening Test

FATFrenchay Arm Test

FMRIFunctional magnetic resonance imaging

ICHInternational Conference on Harmonization

IMBSInstitute of Medical Biometry and Statistics

LOCFLast Observation Carried Forward

MALMotor Activity Log

MMSEMini-Mental-State Examination

MNSMirror neuron system

MRCMedical research council

MRSModified Rankin Scale

PIDPatient identification number

RWTHRheinisch-Westfälische Technische Hochschule

SISStroke Impairment Scale

SMASupplementary motor area

SOPStandard operating procedure

WMFTWolf Motor Function Test.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2377-12-42 contains supplementary material, which is available to authorized users.

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Autor: Denis Ertelt - Claudia Hemmelmann - Christian Dettmers - Andreas Ziegler - Ferdinand Binkofski

Fuente: https://link.springer.com/







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