Imaginería motora: revisión sistemática de su efectividad en la rehabilitación de la extremidad superior tras un ictus / Motor imagery: a systematic review of its effectiveness in the rehabilitation of the upper limb following a stroke

Introducción. La imaginería motora o práctica mental del movimiento es una intervención relativamente nueva, cada vez más empleada en el tratamiento del paciente con ictus. Consiste en la evocación, por parte de la persona, de un movimiento o gesto para aprender o mejorar su ejecución. Estudios de neuroimagen han demostrado que la imaginación de movimientos activa patrones neuronales similares a su ejecución. Pacientes y métodos. Se ha realizado una revisión sistemática entre enero y junio de 2017 en las bases de datos Web of Science, PubMed, CINHAL, PEDro y Scopus, seleccionando los ensayos clínicos llevados a cabo con pacientes con ictus en los que se empleara esta técnica como intervención rehabilitadora. Se incluyeron 13 estudios clínicos aleatorizados. Se resumieron las características de los estudios y las medidas de resultados, y se describió la evidencia de sus resultados. Resultados. La mayor parte de los estudios encuentran diferencias de mejora significativas en la rehabilitación motora de la extremidad superior entre los sujetos de los grupos experimentales. Sólo uno de los estudios no mostró evidencia de su efectividad de forma aislada. En ninguno se hace referencia a su efectividad en la mejora de las alteraciones sensitivas. Conclusiones. La imaginería motora, combinada con terapia convencional (fisioterapia o terapia ocupacional), parece tener efectos positivos en la rehabilitación motora de la extremidad superior tras un ictus. Se precisan más estudios que mejoren la heterogeneidad de las intervenciones y que valoren su efectividad a largo plazo (AU)

Introduction. Motor imagery or mental practice of movement is a relatively new intervention that is being used on an increasingly more frequently basis in the treatment of stroke patients. It consists in the person evoking a movement or gesture in order to learn or improve its execution. Neuroimaging studies have shown that imagining movements activates neuronal patterns that are similar to those produced when they are actually performed. Patients and methods. A systematic review was conducted between January and June 2017 in the Web of Science, PubMed, CINHAL, PEDro and Scopus databases to select clinical trials carried out with stroke patients in whom this technique was used as rehabilitation. Thirteen randomised clinical trials were included. The characteristics of the studies and the measures of results were summarised and the evidence of their outcomes was described. Results. Most of the studies found significant differences in terms of improved motor rehabilitation of the upper limb among the subjects in the experimental groups. Only one of the studies failed to show any evidence of its effectiveness in isolation. None of them made any reference to its effectiveness in improving sensory alterations. Conclusions. Motor imagery, combined with conventional therapy (physiotherapy or occupational therapy), seems to have positive effects on the motor rehabilitation of the upper limb following a stroke. Further research is needed to improve the heterogeneity of the interventions and to evaluate their effectiveness in the long term (AU)

Spanish Transcultural Adaptation and Validity of the Behavioral Inattention Test.

OBJECTIVE: To adapt, validate, and translate the Behavioral Inattention Test as an assessment tool for Spanish individuals with unilateral spatial neglect. DESIGN: A cross-sectional descriptive study. SETTING: University laboratories. PARTICIPANTS: A sample of 75 Spanish stroke patients and 18 healthy control subjects. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The Behavioral Inattention Test. RESULTS: The Spanish version of the Behavioral Inattention Test shows a high degree of reliability both in the complete test (α = .90) and in the conventional (α = .93) and behavioral subtests (α = .75). The concurrent validity between the total conventional and behavioral scores was high (r = -.80; p < 0.001). Significant differences were found between patients with and without unilateral spatial neglect (p < 0.001). In the comparison between right and left damaged sides, differences were found in all items, except for article reading (p = 0.156) and card sorting (p = 0.117). CONCLUSIONS: This measure is a useful tool for evaluating unilateral spatial neglect as it provides information on everyday problems. The BIT discriminates between stroke patients with and without unilateral spatial neglect. This measure constitutes a reliable tool for the diagnosis, planning, performance, and design of specific treatment programs intended to improve the functionality and quality of life of people with unilateral spatial neglect.