| Author: | Wang, Ouyang |
| Title: | The effects of mental rotation training of hands for upper extremity motor function and cognition in post-stroke patients |
| Advisors: | Wong, Thomson (RS) |
| Degree: | DHSc |
| Year: | 2024 |
| Subject: | Cerebrovascular disease -- Patients -- Rehabilitation Hand -- Movements Hong Kong Polytechnic University -- Dissertations |
| Department: | Faculty of Health and Social Sciences |
| Pages: | xii, 92 pages : color illustrations |
| Language: | English |
| Abstract: | Background: Stroke is a leading cause of disability worldwide, impacting mental function, sensory perception, motor skills, cognition, and language. These impairments not only burden the individual but also place significant socioeconomic demands on families and communities. Consequently, there is a pressing need for more effective and accessible rehabilitation strategies. Mental Practice (MP), a technique involving the cognitive rehearsal of physical movements without actual execution, has demonstrated evidence in improving exercise performance and functional tasks in many fields. However, the designs of the clinical stroke studies on MP and the interventions used are very heterogeneous. Among the broader MP approach, the hand rotation task (HRT), which involves the imagined hand rotation, has not been explored in stroke rehabilitation. In terms of mechanism, intensive neuroimaging and transcranial magnetic stimulation research investigating the mental rotation of body parts consistently reports underlying neural mechanisms of activation in a cortico-subcortical network related to motor planning and execution, suggesting a robust neural basis for its potential benefits in stroke recovery. It is possible to establish a more standardized HRT within the context of MP as a treatment protocol in stroke rehabilitation. Based on this, the current study aims to explore the effect of HRT on upper extremity functionality and cognition for post-stroke patients. Methods: Thirty eligible participants were recruited and divided into an intervention group (IG) or a control group (CG). The CG underwent conventional rehabilitation therapies (CRT) for 60 minutes a day, 6 days a week, lasting for 3 weeks, for a total of 18 sessions. Participants in the IG received CRT, with an additional 30 minutes of HRT per day to the CRT. Assessments were performed using the Fugl-Meyer Assessment of Upper Extremity (FMA-UE) as the primary outcome before and after the program. In addition, range of motion (ROM) on wrist pronation and supination, the Action Research Arm Test (ARAT), and the Modified Barthel Index (MBI) were used to evaluate the upper limb function. Cognitive functions were assessed using the Montreal Cognitive Assessment (MoCA). All measures were collected before the intervention (T0) and after the 3-week intervention (T1). Results: Results indicated a significant interaction between time and group in the primary outcome measure, FMA-UE. According to post-hoc analysis, the intervention group's FMA-UE score increased considerably at T1 in comparison to T0. Similarly, a significant Group × Time interaction effect was observed on MBI, where substantial improvements were noted in the intervention group at T1. At baseline (T0), there were no notable differences between groups; however, by T1, these differences approached statistical significance. Additionally, a Group × Time interaction was found by the MoCA-Ch analysis. By comparison, the MoCA score in the intervention group was substantially higher at T1 than it was at T0, according to post-hoc analysis. This was not observed in the control group. At T0, no statistical differences were observed between the groups, but a statistical difference emerged at T1. However, the analysis showed no significant Group × Time interaction effects on ROM of wrist pronation and supination. Moreover, no significant main effects of the group were observed. Conclusion: This study provides evidence that mental rotation of the hand is an effective supplementary therapy for enhancing upper limb function and cognition after stroke and recommends its inclusion in stroke rehabilitation. |
| Rights: | All rights reserved |
| Access: | restricted access |
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| File | Description | Size | Format | |
|---|---|---|---|---|
| 7998.pdf | For All Users (off-campus access for PolyU Staff & Students only) | 10.03 MB | Adobe PDF | View/Open |
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