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ObjectiveTo explore the effects of graded motor imagery (GMI) combined with repetitive transcranial magnetic stimulation (rTMS) on upper limb function and activities of daily living of stroke patients. MethodsFrom June, 2022 to February, 2023, 45 stroke patients from Xuzhou Rehabilitation Hospital and Xuzhou Central Hospital were recruited and divided into control group (n = 15), GMI group (n = 15) and combined group (n = 15) randomly. All the groups received conventional rehabilitation, in addition, GMI group received GMI and the combined group received GMI and rTMS, for four weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Action Research Arm Test (ARAT), modified Barthel Index (MBI) and Hong Kong version of Functional Test for the Hemiplegic Upper Extremity (FTHUE-HK) before and after treatment. ResultsThe scores of FMA-UE, ARAT and MBI, and grades of FTHUE-HK improved in all the groups after treatment (|t| > 9.681, P < 0.001), and all these indexes were the best in the combined group (F > 13.241, P < 0.001). ConclusionGMI combined with rTMS can further improve the motor function of upper limbs and activities of daily living of stroke patients.
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Objective: To observe the effects of Tuina (Chinese therapeutic massage) combined with graded motor imagery (GMI) on the upper-limb motor function and quality of life (QOL) in patients with poststroke hemiplegia.Methods: A total of 216 patients with hemiplegia caused by stroke were randomized into two groups by tossing a coin, with 108 cases in each group. The control group was treated with GMI, and the observation group was given additional Tuina treatment for four weeks in total. Before and after the treatment, the Fugl-Meyer assessment for upper extremity (FMA-UE), supper-limb/hand Brunnstrom staging, box and block test (BBT) for hand, co-contraction ratio (CR) of the upper-limb muscles, visual analog scale (VAS) for shoulder pain, modified Ashworth scale (MAS), modified Barthel index (MBI), and short-form 36-item health survey (SF-36) were adopted for observation of the two groups. Results: After the treatment, the scores of FMA-UE, upper-limb/hand Brunnstrom staging, hand BBT, MBI, and SF-36 increased (P<0.05), and the CR of biceps brachii at flexion, the CR of triceps brachii at extension, and the scores of VAS and MAS decreased in both groups (P<0.05). The scores of FMA-UE, upper-limb/hand Brunnstrom staging, and hand BBT were higher in the observation group than in the control group after the intervention (P<0.05); the CR of biceps brachii at flexion and the CR of triceps brachii at extension were lower in the observation group than in the control group (P<0.05). After the treatment, the scores of MBI and SF-36 were higher in the observation group than in the control group (P<0.05), and the scores of VAS and MAS were lower in the observation group than in the control group (P<0.05). Conclusion: Tuina combined with GMI can produce more significant effects in improving the upper-limb motor function and QOL in patients with hemiplegia after stroke.
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Objective To investigate the effect of graded motor imagery ( GMI) therapy combined with rou-tine occupational therapy on the recovery of upper extremity function after stroke. Methods Thirty stroke survivors who met inclusion criteria were randomly assigned to a control group ( n=15) or a GMI group ( n=15) . The control group received routine medication, conventional physical therapy and routine occupational therapy ( one hour a day) , while the GMI group received 30 minutes of routine occupational therapy and 30 minutes of graded motor imagery therapy every day in addition to conventional medication and physical therapy. Before and after four weeks of treat-ment, the patients in both groups were evaluated using the Fugl-Meyer Assessment for the Upper Extremities ( FMA-UE) , the Box and Block Test ( BBT) and Brunnstrom arm and hand staging. Surface electromyography of the biceps brachii and triceps brachii was performed as the affected elbow flexed and stretched in maximum isometric contrac-tions, and the co-contraction ratios ( CRs) were calculated. Results After the treatment, the average FMA-UE score, Brunnstrom arm and hand stage, BBT and CR scores in both groups had improved significantly. The average improvement in the GMI group was significantly greater than in the control group. Conclusions Graded motor im-agery therapy can significantly promote motor recovery of the upper extremities of hemiplegic patients after a stroke.