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Effects of associated therapies of motor imagery and constraint-induced movement in chronic hemiparesis: a case study

This study assessed the efficacy of the association of motor imagery and constraint-induced movement therapies in functional rehabilitation of the upper limb in a patient with somatosensory and motor deficits following stroke. Motor imagery (MI) therapy, i.e., mental simulation of body image, consisted in: 1st, mirror visual stimulus, at three 30-60-minute weekly sessions for four weeks; and 2nd, MI with mental practice, at three 15-minute sessions per week for three weeks. Lastly, constraint-induced movement therapy was applied for 14 days, in 10 of which the patient underwent 6 hours daily of paretic limb functional training. The patient was assessed at baseline and at the end of each therapy modality as to clinical examination of sensation; hand grip strength; shoulder, elbow and wrist range of motion; and the motor assessment scale (MAS) was applied. Scores obtained at the four assessment moments were statistically compared. Results showed significant differences (p<0.05) after treatment: increased range of motion at all upper limb joints, increased hand grip strength, decrease in time of task performance at MAS, and recovery of clinical sensation, especially tactile detection and pressure sense. The association of IM and constraint-induced therapies thus proved effective in functional rehabilitation of the upper limb of the poststroke patient with chronic hemiparesis.

Mental healing; Paresis; Physical therapy modalities; Stroke


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