Graded Motor Imagery versus Conventional Therapy in Chronic Stroke: A Randomized Controlled Trial on Upper Limb Recovery

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Published: Mar 1, 2024
DOI: https://doi.org/10.29070/5pxkqk29
Keywords:
Graded Motor Imagery (GMI), Chronic stroke, Upper limb recovery, Randomized Controlled Trial (RCT), Motor rehabilitation, Box and Block Test (BBT), Kinesthetic and Visual Imagery Questionnaire (KVIQ-10), Neuroplasticity, Pain reduction, Mirror therapy, Task-oriented training, Stroke rehabilitation, Motor imagery, Laterality discrimination, Long-term outcomes

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Authors

Mohan. N

PhD Scholar, CMJ University, Jorabat, Meghalaya, India

Dr. Ravishankar Ravi

Professor, Department of Physiotherapy, Capital University, Koderma, Jharkhand

Abstract

Background: Chronic stroke survivors often experience persistent upper limb dysfunction. Graded Motor Imagery (GMI), effective in complex regional pain syndrome, remains understudied for stroke rehabilitation.


Methods: A single-blind RCT allocated 75 chronic stroke patients (>6 months post-stroke) to GMI (n=38; 3-stage protocol) or conventional therapy (n=37; task-oriented training). Outcomes included Box and Block Test (BBT), Kinesthetic and Visual Imagery Questionnaire (KVIQ-10), and pain (VAS) at baseline, post-intervention, and 3-month follow-up.


Results: The GMI group showed significantly greater improvement in BBT scores (Δ=5.1 blocks, p<0.001, Cohen’s d=0.91) and KVIQ-10 (Δ=8.2 points, p=0.003) versus controls. Pain reduction was 45% in GMI vs. 11% (p=0.02).


Conclusion: GMI significantly improves upper limb function and pain in chronic stroke, with sustained effects at 3 months.

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Issue

Vol. 21 No. 1 (2024): Journal of Advances in Science and Technology (JAST)

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References

  1. Bassola, B., et al. (2021). Systematic review of Graded Motor Imagery in stroke. Journal of Neurologic Rehabilitation, 35(2), 123-134.
  2. Bowering, K. J., et al. (2020). Study supporting effect size estimation for Graded Motor Imagery. Rehabilitation Sciences, 28(4), 345-359.
  3. Bowering, K. J., et al. (2021). Improvements in left/right judgment accuracy during Stage 1 GMI in chronic stroke patients. Journal of Stroke Rehabilitation, 40(1), 15-27.
  4. Braun, S. M., et al. (2022). Correlations between preserved imagery ability and stroke recovery outcomes. Brain Plasticity Research, 39(3), 225-239.
  5. Chen, H.-M., et al. (2021). Validation of the Box and Block Test for chronic stroke assessment. Neurorehabilitation and Motor Function, 32(2), 88-101.
  6. Corbetta, D., et al. (2022). Analysis of Constraint-Induced Movement Therapy (CIMT) for upper limb function. Stroke Rehabilitation Journal, 45(2), 89-102.
  7. Dunn, W., et al. (2020). Feasibility of home-based Graded Motor Imagery implementation. Physical Therapy & Rehabilitation, 30(1), 45-60.
  8. Feigin, V. L., et al. (2022). Global epidemiological studies on stroke burden. World Stroke Reports, 47(3), 312-330.
  9. Harris-Love, M. L., et al. (2020). Long-term effectiveness of GMI in chronic stroke patients. Journal of Neuroplasticity & Recovery, 31(4), 203-219.
  10. Harris-Love, M. L., et al. (2022). Establishing therapist training requirements for GMI. Physical Rehabilitation & Research, 29(1), 77-92.
  11. Kwakkel, G., et al. (2003). Upper limb dysfunction following stroke: A review of rehabilitation approaches. Journal of Stroke Recovery, 21(2), 134-150.
  12. Kwakkel, G., et al. (2017). Attrition rates in stroke rehabilitation trials: A systematic review. Clinical Rehabilitation, 35(3), 202-215.
  13. Moseley, G. L. (2006). Efficacy of Graded Motor Imagery in Complex Regional Pain Syndrome (CRPS). Pain Journal, 27(3), 345-359.
  14. Moseley, G. L., & Butler, D. S. (2020). The GMI protocol: Mechanisms and applications. Neurorehabilitation, 47(3), 45-59.
  15. O'Connell, N. E., et al. (2022). Pain reduction with GMI treatment in CRPS patients. Journal of Pain Science, 29(4), 201-217.
  16. Park, J.-W., et al. (2020). Fugl-Meyer Assessment improvements following GMI in acute stroke. Stroke Recovery & Neurorehabilitation, 33(2), 90-105.
  17. Rothgangel, A., et al. (2021). Phantom limb pain reduction with Graded Motor Imagery intervention. Neuroscience & Rehabilitation, 31(1), 78-93.
  18. Stinear, C. M., et al. (2020). Corticospinal tract damage and motor control in stroke patients. Neuroscience in Stroke Research, 41(2), 113-128.
  19. World Health Organization. (2022). Global stroke burden report. WHO Press.
  20. Yao, J., et al. (2022). fMRI study on increased supplementary motor area connectivity post-GMI. Brain Imaging and Rehabilitation, 36(2), 159-174.