Research

Study: Blend of Mental Practice and PT Effective as Stroke Treatment

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stroke

Researchers at Georgia State University report that blending mental practice with physical therapy can be an effective treatment for individuals recovering from stroke. A university news release states that the findings investigate how the brains of stroke patients change after treatment.

The study encompassed a total of 17 young, healthy controls and 13 aged stroke survivors. The release says stroke participants were placed in two different groups for rehabilitation. The first group was mental practice only, and the second group included both mental practice and physical therapy. Stroke survivors received the treatment within 14 to 51 days of their stroke and participated in 60 total hours of rehabilitation.

The results appear in the journal Frontiers in Human Neuroscience.

According to the release, researchers determined the effectiveness of these treatments by performing functional magnetic resonance imaging (fMRI) scans on the control group and on the stroke survivors prior to and after their treatment.

The fMRI scans were reportedly performed while participants were inactive and determined the network activity of five core areas of the brain linked to motor execution.These areas included the left primary motor area (LM1), right primary motor area (RM1), left pre-motor cortex (LPMC), right pre-motor cortex (RPMC) and supplementary motor area (SMA).

Multiple cortical areas of the brain communicate with each other during normal brain function, the release says, however these interactions are disrupted post-stroke. The study focused on the impact of stroke on these interactions and how function is regained from rehabilitation as individuals begin to recover motor behaviors.

Once a stroke has been sustained, brain cells are damaged and “it takes a long time for neurons to grow back, if at all. You can use certain treatments to make the brain adapt or compensate in order to recruit new neurons and make you move again,” explains Andrew Butler, interim dean, Byrdine F. Lewis School of Nursing and Health Professions and associate faculty in the Neuroscience Institute at Georgia State.

“One of these treatments is really intense physical therapy, but some people can’t move at all. We found in our data that if they just think about moving, it keeps the neurons active right around the area that died in the brain. We used mental practice as a primer for physical training. As people improve and move along in their rehabilitation, they can progress from mental practice to physical practice and this can result in behavioral change, meaning they could move their arms better,” Butler adds in the release.

The team, the release states, found that the causal flow of information between several brain regions was reduced significantly for stroke survivors.

Brain connections that were significantly reduced include LM1 and SMA, RPMC and SMA, RPMC and LM1, SMA and RM1, and SMA and LPMC. This flow of information did not increase significantly after mental practice alone, yet it increased significantly when mental practice and physical therapy were combined, the study says.

Additionally, the release points out that sensation and motor function scores were significantly higher when stroke survivors underwent the combined mental practice and physical therapy.

The results indicate that a combination of mental practice and physical therapy can be an effective means of treatment for stroke survivors to recover or regain strength of motor behaviors. The results also suggest that causal information flow can be a reliable way to evaluate rehabilitation in stroke survivors.

Source(s): ScienceDaily, Georgia State University