Effect of the combination of motor imagery and electrical stimulation on upper extremity motor function in patients with chronic stroke: preliminary results

Kohei Okuyama, Miho Ogura, Michiyuki Kawakami, Kengo Tsujimoto, Kohsuke Okada, Kazuma Miwa, Yoko Takahashi, Kaoru Abe, Shigeo Tanabe, Tomofumi Yamaguchi, Meigen Liu

研究成果: Article

3 引用 (Scopus)

抄録

Background: The combination of motor imagery (MI) and afferent input with electrical stimulation (ES) enhances the excitability of the corticospinal tract compared with motor imagery alone or electrical stimulation alone. However, its therapeutic effect is unknown in patients with hemiparetic stroke. We performed a preliminary examination of the therapeutic effects of MI + ES on upper extremity (UE) motor function in patients with chronic stroke. Methods: A total of 10 patients with chronic stroke demonstrating severe hemiparesis participated. The imagined task was extension of the affected finger. Peripheral nerve electrical stimulation was applied to the radial nerve at the spiral groove. MI + ES intervention was conducted for 10 days. UE motor function as assessed with the Fugl–Meyer assessment UE motor score (FMA-UE), the amount of the affected UE use in daily life as assessed with a Motor Activity Log (MAL-AOU), and the degree of hypertonia in flexor muscles as assessed with the Modified Ashworth Scale (MAS) were evaluated before and after intervention. To assess the change in spinal neural circuits, reciprocal inhibition between forearm extensor and flexor muscles with the H reflex conditioning-test paradigm at interstimulus intervals (ISIs) of 0, 20, and 100 ms were measured before and after intervention. Results: UE motor function, the amount of the affected UE use, and muscle hypertonia in flexor muscles were significantly improved after MI + ES intervention (FMA-UE: p < 0.01, MAL-AOU: p < 0.01, MAS: p = 0.02). Neurophysiologically, the intervention induced restoration of reciprocal inhibition from the forearm extensor to the flexor muscles (ISI at 0 ms: p = 0.03, ISI at 20 ms: p = 0.03, ISI at 100 ms: p = 0.01). Conclusion: MI + ES intervention was effective for improving UE motor function in patients with severe paralysis.

元の言語English
ジャーナルTherapeutic Advances in Neurological Disorders
11
DOI
出版物ステータスPublished - 01-01-2018

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Imagery (Psychotherapy)
Upper Extremity
Electric Stimulation
Stroke
Muscles
Therapeutic Uses
Forearm
Muscle Hypertonia
H-Reflex
Radial Nerve
Pyramidal Tracts
Paresis
Peripheral Nerves
Paralysis
Fingers
Motor Activity

All Science Journal Classification (ASJC) codes

  • Pharmacology
  • Neurology
  • Clinical Neurology

これを引用

Okuyama, Kohei ; Ogura, Miho ; Kawakami, Michiyuki ; Tsujimoto, Kengo ; Okada, Kohsuke ; Miwa, Kazuma ; Takahashi, Yoko ; Abe, Kaoru ; Tanabe, Shigeo ; Yamaguchi, Tomofumi ; Liu, Meigen. / Effect of the combination of motor imagery and electrical stimulation on upper extremity motor function in patients with chronic stroke : preliminary results. :: Therapeutic Advances in Neurological Disorders. 2018 ; 巻 11.
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title = "Effect of the combination of motor imagery and electrical stimulation on upper extremity motor function in patients with chronic stroke: preliminary results",
abstract = "Background: The combination of motor imagery (MI) and afferent input with electrical stimulation (ES) enhances the excitability of the corticospinal tract compared with motor imagery alone or electrical stimulation alone. However, its therapeutic effect is unknown in patients with hemiparetic stroke. We performed a preliminary examination of the therapeutic effects of MI + ES on upper extremity (UE) motor function in patients with chronic stroke. Methods: A total of 10 patients with chronic stroke demonstrating severe hemiparesis participated. The imagined task was extension of the affected finger. Peripheral nerve electrical stimulation was applied to the radial nerve at the spiral groove. MI + ES intervention was conducted for 10 days. UE motor function as assessed with the Fugl–Meyer assessment UE motor score (FMA-UE), the amount of the affected UE use in daily life as assessed with a Motor Activity Log (MAL-AOU), and the degree of hypertonia in flexor muscles as assessed with the Modified Ashworth Scale (MAS) were evaluated before and after intervention. To assess the change in spinal neural circuits, reciprocal inhibition between forearm extensor and flexor muscles with the H reflex conditioning-test paradigm at interstimulus intervals (ISIs) of 0, 20, and 100 ms were measured before and after intervention. Results: UE motor function, the amount of the affected UE use, and muscle hypertonia in flexor muscles were significantly improved after MI + ES intervention (FMA-UE: p < 0.01, MAL-AOU: p < 0.01, MAS: p = 0.02). Neurophysiologically, the intervention induced restoration of reciprocal inhibition from the forearm extensor to the flexor muscles (ISI at 0 ms: p = 0.03, ISI at 20 ms: p = 0.03, ISI at 100 ms: p = 0.01). Conclusion: MI + ES intervention was effective for improving UE motor function in patients with severe paralysis.",
author = "Kohei Okuyama and Miho Ogura and Michiyuki Kawakami and Kengo Tsujimoto and Kohsuke Okada and Kazuma Miwa and Yoko Takahashi and Kaoru Abe and Shigeo Tanabe and Tomofumi Yamaguchi and Meigen Liu",
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Effect of the combination of motor imagery and electrical stimulation on upper extremity motor function in patients with chronic stroke : preliminary results. / Okuyama, Kohei; Ogura, Miho; Kawakami, Michiyuki; Tsujimoto, Kengo; Okada, Kohsuke; Miwa, Kazuma; Takahashi, Yoko; Abe, Kaoru; Tanabe, Shigeo; Yamaguchi, Tomofumi; Liu, Meigen.

:: Therapeutic Advances in Neurological Disorders, 巻 11, 01.01.2018.

研究成果: Article

TY - JOUR

T1 - Effect of the combination of motor imagery and electrical stimulation on upper extremity motor function in patients with chronic stroke

T2 - preliminary results

AU - Okuyama, Kohei

AU - Ogura, Miho

AU - Kawakami, Michiyuki

AU - Tsujimoto, Kengo

AU - Okada, Kohsuke

AU - Miwa, Kazuma

AU - Takahashi, Yoko

AU - Abe, Kaoru

AU - Tanabe, Shigeo

AU - Yamaguchi, Tomofumi

AU - Liu, Meigen

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: The combination of motor imagery (MI) and afferent input with electrical stimulation (ES) enhances the excitability of the corticospinal tract compared with motor imagery alone or electrical stimulation alone. However, its therapeutic effect is unknown in patients with hemiparetic stroke. We performed a preliminary examination of the therapeutic effects of MI + ES on upper extremity (UE) motor function in patients with chronic stroke. Methods: A total of 10 patients with chronic stroke demonstrating severe hemiparesis participated. The imagined task was extension of the affected finger. Peripheral nerve electrical stimulation was applied to the radial nerve at the spiral groove. MI + ES intervention was conducted for 10 days. UE motor function as assessed with the Fugl–Meyer assessment UE motor score (FMA-UE), the amount of the affected UE use in daily life as assessed with a Motor Activity Log (MAL-AOU), and the degree of hypertonia in flexor muscles as assessed with the Modified Ashworth Scale (MAS) were evaluated before and after intervention. To assess the change in spinal neural circuits, reciprocal inhibition between forearm extensor and flexor muscles with the H reflex conditioning-test paradigm at interstimulus intervals (ISIs) of 0, 20, and 100 ms were measured before and after intervention. Results: UE motor function, the amount of the affected UE use, and muscle hypertonia in flexor muscles were significantly improved after MI + ES intervention (FMA-UE: p < 0.01, MAL-AOU: p < 0.01, MAS: p = 0.02). Neurophysiologically, the intervention induced restoration of reciprocal inhibition from the forearm extensor to the flexor muscles (ISI at 0 ms: p = 0.03, ISI at 20 ms: p = 0.03, ISI at 100 ms: p = 0.01). Conclusion: MI + ES intervention was effective for improving UE motor function in patients with severe paralysis.

AB - Background: The combination of motor imagery (MI) and afferent input with electrical stimulation (ES) enhances the excitability of the corticospinal tract compared with motor imagery alone or electrical stimulation alone. However, its therapeutic effect is unknown in patients with hemiparetic stroke. We performed a preliminary examination of the therapeutic effects of MI + ES on upper extremity (UE) motor function in patients with chronic stroke. Methods: A total of 10 patients with chronic stroke demonstrating severe hemiparesis participated. The imagined task was extension of the affected finger. Peripheral nerve electrical stimulation was applied to the radial nerve at the spiral groove. MI + ES intervention was conducted for 10 days. UE motor function as assessed with the Fugl–Meyer assessment UE motor score (FMA-UE), the amount of the affected UE use in daily life as assessed with a Motor Activity Log (MAL-AOU), and the degree of hypertonia in flexor muscles as assessed with the Modified Ashworth Scale (MAS) were evaluated before and after intervention. To assess the change in spinal neural circuits, reciprocal inhibition between forearm extensor and flexor muscles with the H reflex conditioning-test paradigm at interstimulus intervals (ISIs) of 0, 20, and 100 ms were measured before and after intervention. Results: UE motor function, the amount of the affected UE use, and muscle hypertonia in flexor muscles were significantly improved after MI + ES intervention (FMA-UE: p < 0.01, MAL-AOU: p < 0.01, MAS: p = 0.02). Neurophysiologically, the intervention induced restoration of reciprocal inhibition from the forearm extensor to the flexor muscles (ISI at 0 ms: p = 0.03, ISI at 20 ms: p = 0.03, ISI at 100 ms: p = 0.01). Conclusion: MI + ES intervention was effective for improving UE motor function in patients with severe paralysis.

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