Effects of Mirror Therapy on Motor Imagery Elicited ERD/S: An EEG Study on Healthy Subjects

Reciprocal communication of the central and peripheral nervous systems is compromised during spinal cord injury due to neurotrauma of ascending and descending pathways. Changes in brain organization after spinal cord injury have been associated with differences in prognosis. Changes in functional connectivity may also serve as injury biomarkers. Most studies on functional connectivity have focused on chronic complete injury or resting-state condition. In our study, ten right-handed patients with incomplete spinal cord injury and ten age- and gender-matched healthy controls performed multiple visual motor imagery tasks of upper extremities and walking under high-resolution electroencephalography recording. Directed transfer function was used to study connectivity at the cortical source space between sensorimotor nodes. Chronic disruption of reciprocal communication in incomplete injury could result in permanent significant decrease of connectivity in a subset of the sensorimotor network, regardless of positive or negative neurological outcome. Cingulate motor areas consistently contributed the larger outflow (right) and received the higher inflow (left) among all nodes, across all motor imagery categories, in both groups. Injured subjects had higher outflow from left cingulate than healthy subjects and higher inflow in right cingulate than healthy subjects. Alpha networks were less dense, showing less integration and more segregation than beta networks. Spinal cord injury patients showed signs of increased local processing as adaptive mechanism. This trial is registered with NCT02443558.

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Current knowledge on selected rehabilitative methods used in post-stroke recovery

Rehabilitacja Medyczna ◽

10.5604/01.3001.0011.6823 ◽

2018 ◽

Vol 21 (3) ◽

pp. 51-57

Author(s):

Pawel Kiper ◽

Aneta Pirowska ◽

Joanna Stożek ◽

Alfonc Baba ◽

Michela Agostini ◽

...

Keyword(s):

Motor Imagery ◽

Brain Plasticity ◽

Current Knowledge ◽

Stroke Recovery ◽

Active Movement ◽

Phantom Pain ◽

Mirror Therapy ◽

Therapeutic Modalities ◽

Constraint Induced Movement Therapy ◽

Motor Network

Understanding brain plasticity after stroke is important in developing rehabilitation strategies. Active movement therapies show considerable promise but their individual application is still not fully implemented. Among the analysed, available therapeutic modalities, some became widely used in therapeutic practice. Thus, we selected three relatively new methods, i.e. mirror therapy, motor imagery and constraint-induced movement therapy (CIMT). Mirror therapy was initially used in the treatment of phantom pain in patients with amputated limbs and later, in stroke patients. Motor imagery is widely used in sport to improve performance, which raises the possibility of applying it both as a rehabilitative method and in accessing the motor network independently of recovery. Whereas CIMT is based on the paradigm that impairment of arm function is exacerbated by learned non-use and that this, in turn, leads to loss of cortical representation in the upper limb.

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Mirror therapy, graded motor imagery and virtual illusion for the management of chronic pain

10.1002/14651858.cd010329 ◽

2013 ◽

Cited By ~ 3

Author(s):

Lieszel Plumbe ◽

Susan Peters ◽

Sally Bennett ◽

Bill Vicenzino ◽

Michel W Coppieters

Keyword(s):

Chronic Pain ◽

Motor Imagery ◽

Mirror Therapy ◽

Graded Motor Imagery

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Update on the effects of graded motor imagery and mirror therapy on complex regional pain syndrome type 1: A systematic review

Journal of Back and Musculoskeletal Rehabilitation ◽

10.3233/bmr-150500 ◽

2017 ◽

Vol 30 (3) ◽

pp. 441-449 ◽

Cited By ~ 10

Author(s):

Guillermo Méndez-Rebolledo ◽

Valeska Gatica-Rojas ◽

Rafael Torres-Cueco ◽

María Albornoz-Verdugo ◽

Eduardo Guzmán-Muñoz

Keyword(s):

Systematic Review ◽

Complex Regional Pain Syndrome ◽

Motor Imagery ◽

Pain Syndrome ◽

Syndrome Type ◽

Mirror Therapy ◽

Graded Motor Imagery

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Effectiveness of mirror therapy, motor imagery, and virtual feedback on phantom limb pain following amputation: A systematic review

Prosthetics and Orthotics International ◽

10.1177/0309364617740230 ◽

2017 ◽

Vol 42 (3) ◽

pp. 288-298 ◽

Cited By ~ 22

Author(s):

Laura Herrador Colmenero ◽

Jose Manuel Perez Marmol ◽

Celia Martí-García ◽

María de los Ángeles Querol Zaldivar ◽

Rosa María Tapia Haro ◽

...

Keyword(s):

Systematic Review ◽

Motor Imagery ◽

Visual Feedback ◽

Methodological Quality ◽

Internal Validity ◽

Phantom Limb Pain ◽

Research Quality ◽

Phantom Limb ◽

Mirror Therapy ◽

Limb Pain

Background: Phantom limb pain is reported in 50%–85% of people with amputation. Clinical interventions in treating central pain, such as mirror therapy, motor imagery, or virtual visual feedback, could redound in benefits to amputee patients with phantom limb pain. Objectives: To provide an overview of the effectiveness of different techniques for treating phantom limb pain in amputee patients. Study design: Systematic review. Methods: A computerized literature search up to April 2017 was performed using the following databases: PubMed, Scopus, CINAHL, MEDLINE, ProQuest, PEDro, EBSCOhost, and Cochrane Plus. Methodological quality and internal validity score of each study were assessed using PEDro scale. For data synthesis, qualitative methods from the Cochrane Back Review Group were applied. Results: In all, 12 studies met our inclusion criteria, where 9 were rated as low methodological quality and 3 rated moderate quality. All studies showed a significant reduction in pain, but there was heterogeneity among subjects and methodologies and any high-quality clinical trial (PEDro score ≤8; internal validity score ≤5) was not found. Conclusion: Mirror therapy, motor imaginary, and virtual visual feedback reduce phantom limb pain; however, there is limited scientific evidence supporting their effectiveness. Future studies should include designs with more solid research methods, exploring short- and long-term benefits of these therapies. Clinical relevance This systematic review investigates the effectiveness of mirror therapy, motor imagery, and virtual visual feedback on phantom limb pain, summarizing the currently published trials and evaluating the research quality. Although these interventions have positive benefits in phantom limb pain, there is still a lack of evidence for supporting their effectiveness.

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POST STROKE REHABILITATION: CLINICAL EFFICACY OF BCI-DRIVEN HAND EXOSKELETON IN COMPARISON WITH "AMADEO" ROBOTIC MECHANOTHERAPY

Physical and rehabilitation medicine, medical rehabilitation ◽

10.36425/2658-6843-2019-3-63-72 ◽

2019 ◽

Vol 1 (3) ◽

pp. 63-72 ◽

Cited By ~ 2

Author(s):

R Kh Lyukmanov ◽

O A Mokienko ◽

G A Aziatskaya ◽

N A Suponeva ◽

M A Piradov

Keyword(s):

Motor Function ◽

Motor Imagery ◽

Stroke Rehabilitation ◽

Treatment Strategies ◽

Main Group ◽

Motor Deficit ◽

Control Group ◽

Mirror Therapy ◽

Robot Assisted ◽

Post Stroke

Motor function deficit due to stroke is one of the leading causes for disability among working-age population. The most effective evidence-based treatment strategies are task oriented exercise approaches including constrained-induced movement therapy. Robot-assisted training provides high amount of repetitions and feedback to patient. Adjuvant therapies such as mirror therapy and motor imagery show their effectiveness if used in combination with basic neurorehabilitation methods and are treatment of choice for patients with severe motor impairment. Brain-computer interfaces allow to control motor imagery as a process by giving different type of feedback (e.g. kinesthetic via exoskeleton) during training sessions. It is poorly known if kinesthetic motor imagery is more effective comparing to robot-assisted training as a part of post-stroke rehabilitation. Materials and methods: 55 patients with arm paresis >1 month after stroke were enrolled in the current study. Screening and randomization were performed. Participants underwent rehabilitation treatment where BCI controlled motor imagery training in main group and robot-assisted training in control group were included. Motor function of the paretic arm was assessed using Action Research Arm Test (ARAT) and Fugl-Meyer Assessment (FMA) before and after intervention. Results: Recovery of upper extremity motor function did not correlate with time since stroke and age of participants neither in main group, nor in control group. Correlations between change in motor scales scores and initial severity of motor deficit was shown in both groups (p

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Motor Imagery-Based Brain-Computer Interface Coupled to a Robotic Hand Orthosis Aimed for Neurorehabilitation of Stroke Patients

Journal of Healthcare Engineering ◽

10.1155/2018/1624637 ◽

2018 ◽

Vol 2018 ◽

pp. 1-10 ◽

Cited By ~ 15

Author(s):

Jessica Cantillo-Negrete ◽

Ruben I. Carino-Escobar ◽

Paul Carrillo-Mora ◽

David Elias-Vinas ◽

Josefina Gutierrez-Martinez

Keyword(s):

Spatial Pattern ◽

Motor Imagery ◽

Healthy Subjects ◽

Robotic Hand ◽

Hand Rehabilitation ◽

Stroke Patients ◽

Common Spatial Pattern ◽

Processing Stage ◽

The Common ◽

Low Performance

Motor imagery-based brain-computer interfaces (BCI) have shown potential for the rehabilitation of stroke patients; however, low performance has restricted their application in clinical environments. Therefore, this work presents the implementation of a BCI system, coupled to a robotic hand orthosis and driven by hand motor imagery of healthy subjects and the paralysed hand of stroke patients. A novel processing stage was designed using a bank of temporal filters, the common spatial pattern algorithm for feature extraction and particle swarm optimisation for feature selection. Offline tests were performed for testing the proposed processing stage, and results were compared with those computed with common spatial patterns. Afterwards, online tests with healthy subjects were performed in which the orthosis was activated by the system. Stroke patients’ average performance was 74.1 ± 11%. For 4 out of 6 patients, the proposed method showed a statistically significant higher performance than the common spatial pattern method. Healthy subjects’ average offline and online performances were of 76.2 ± 7.6% and 70 ± 6.7, respectively. For 3 out of 8 healthy subjects, the proposed method showed a statistically significant higher performance than the common spatial pattern method. System’s performance showed that it has a potential to be used for hand rehabilitation of stroke patients.

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