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IRCT20220430054702N1 IRCT 2023-06-20 Tehran University of Medical Sciences The effectiveness of mental imagery in people with stroke Effectiveness of Mental Imagery on the Occupational Performance and Life Habits of Persons with Stroke 2022-05-21 anticipated 68 Complete https://irct.ir/trial/63300 interventional Randomization: Randomized, Blinding: Single blinded, Placebo: Not used, Assignment: Factorial, Purpose: Supportive, Randomization description: The samples will then be divided into control and intervention groups by block randomization method. In the block randomization method, first all 4 blocks that contain two letters A and B are prepared (6 blocks) and we assign a number from 1 to 6 to each of them. Then, using a table of random numbers, numbers from one to six are selected (15 numbers) and the corresponding block will be written based on the selected random number. Doing so will result in a sequence of 60 letters A and B. Each sample will have a number from 1 to 60 if they enter the study, which will receive an A or B code based on the letter list based on each person's number. This is both a coincidence and both groups will be approximately the same, Blinding description: In this study, the evaluation is performed by an occupational therapist who is fluent in the tests and is not part of the research team and is not aware of the study process (the evaluator is blind). N/A Stroke. Intervention 1: Intervention group: available samples are included in the study based on the inclusion criteria. Then clients fill part of the demographic information questionnaire and enter the intervention group (routine occupational therapy with mental imagery), daily life habits are measured using the life habits questionnaire (H-Life). Then, the work performance priorities of the samples in the three areas of productivity, self-care and leisure time are determined using the Canadian Work Performance Scale (COPM), and the intervention should be carried out on these priorities. Clients perform their priority functions with the healthy side and using video rotation software, the prepared video is returned and sent to the clients. In the video made, it seems that the person with the involved side is doing an activity, and the video contains 5 functions that are a priority for the reference, and the duration of the video for each function is one minute (5 minutes in total). . Clients should view this video of priority functions before performing the visualization. which later visualizes these priority functions during the therapy session. Intervention protocol: 1- Mental imagery intervention for the intervention group: Mental imagery includes three parts: relaxation, imagination (visualization of prioritized functions) and normalization. The relaxation part (three minutes), fantasy or visualization of priority functions (5 minutes) and normalization (two minutes), which are 10 minutes in total. Mental imagery exercises are performed three times a day (for a total of 30 minutes), 3 times a week for 4 weeks. In all parts, the person should sit in a relaxed and comfortable position (the environment should have minimal noise and distractions). The first part of relaxation: relaxation; It includes three stages of breathing exercises, visualization of a relaxing environment and muscle relaxation. The whole relaxation part lasts for 3 minutes. The first stage of sedation or respiratory sedation; The person is asked to count to 4 and inhale through the nose while counting and then hold his breath and count to 4, then while breathing out to count to 4, finally without breathing again or Exhale for a count of 4 and repeat this process for 25 seconds. The second stage of relaxation; Imagining a relaxing environment: In this step, the person is asked to create a relaxing environment by remembering a relaxing environment or through imagination (for example, a day at the beach or in the forest). The elements of the environment using each of the five senses using commands such as: What do you see? (for example, the blue color of water), . what do you hear (eg waves crashing along the shore), what do you smell? (For example, the fruity scent of sunscreen), what do you smell? (eg, salty sea air), how do you feel? (for example, the heat of the sun). In total, this stage of relaxation takes 50 seconds. The third stage of relaxation; It is muscle relaxation, which consists of 6 steps and includes the following exercises: 1. Starting from the foot, bend the toes under and contract the leg muscles. Hold for 5 seconds, then slowly release for 10 seconds. 2. Contract the calf muscles. Hold for 5 seconds, then release slowly for 10 seconds. 3. Contract the buttock muscles. Hold for 5 seconds, then slowly release for 10 seconds. 4. Contract the abdominal and chest muscles. Hold for 5 seconds, then slowly release for 10 seconds. 5. Contract the shoulder muscles. Hold for 5 seconds, then release slowly for 10 seconds. 6. Contract the muscles of the face (for example, squeeze the eyes). Hold for 5 seconds, then slowly release for 10 seconds. 7. Contract the hand muscles and make a fist. Hold for 5 seconds, then slowly release for 10 seconds. A total of 105 seconds are spent on relaxing the muscles. Second part: imagining and visualizing priority functions; In this section, the references visualize the video made of the priority functions, the duration of which is 5 minutes, and one minute of visualization is considered for each function. The third part: normalization; in this stage, the client is asked to pay attention to the surrounding environment and the real position of his body, and the duration of this stage is 2 minutes. In total, it takes 10 minutes to complete all the mental imaging sections. Therefore, in every session that the client intends to visualize, he must repeat it 3 times a day, which takes a total of 30 minutes of visualization. 2- Routine occupational therapy intervention for the intervention group: Routine occupational therapy includes; Upper body exercises for 15 minutes: carrying a cube, pegboard, holding a cup and sliding objects on the table. Also, 15 minutes of exercises for the lower body: changing from sitting to standing, reaching sitting positions, walking and crossing obstacles, turning and transferring), 30 minutes per session, 3 times a week for 4 weeks. Takes. Intervention 2: Control group: Includes routine occupational therapy, which includes upper extremity exercises for 15 minutes: carrying a cube, pegboard, holding a cup, and sliding objects on a table. Also, 15 minutes of exercises for the lower body: changing from sitting to standing, reaching sitting positions, walking and crossing obstacles, turning and transferring), 30 minutes per session, 3 times a week for 4 weeks. Takes. Yes - There is a plan to make this available What will be shared: Data related to demographic questionnaires and Canadian life habits and performance are presented in summary form, separately and in files. When: The access period starts 6 months after the results are published. To whom: Clients and professors, advisors, guides and all researchers Conditions: The general researchers are allowed to use any type of analysis. Where to obtain: Send to the recipient's email address. How to obtain: Send to the recipient's email address. Comments:
public Amir Mohammad Homayoni
Faculty of Rehabilitation, Corner of Safi Alishah St., Pich Shemiran St., Tehran
Tehran Iran (Islamic Republic of) 65111-11489 +98 21 7753 3939 a.m.homayooni@gmail.com Tehran University of Medical Sciences scientific Amir Mohammad Homayoni
Faculty of Rehabilitation, corner of Safi Alishah St., Pich Shemiran St., Tehran
Tehran Iran (Islamic Republic of) 65111-11489 +98 21 7753 3939 a.m.homayooni@gmail.com Tehran University of Medical Sciences Iran (Islamic Republic of) Iran (Islamic Republic of) People with adult stroke are in the age range of 30-65 who have at least one chronic unilateral stroke, on the other hand, the interval between the onset of the disease is six months or more. References can walk at least 10 meters with or without a cane. Lack of perceptual aphasia No unilateral neglect No severe depression Be literate Lack of articular contractures affecting movement Clients have appropriate communication skills and have a minimum mental state examination score (MMSE) of 21 and above to be able to be intervened. Severe hemiplegic spasticity (modified Ashworth Scale score at least 3) 30 years 65 years Both Any severe upper limb pain, with a score greater than or equal to 5 on the analog visual scale Bad general conditions such as medical or orthopedic problems that have prevented clients from participating in normal rehabilitation Combined neurological diseases such as Parkinson's disease are present in clients G46 Vascular syndromes of brain in cerebrovascular diseases Rehabilitation Rehabilitation Intervention group: available samples are included in the study based on the inclusion criteria. Then clients fill part of the demographic information questionnaire and enter the intervention group (routine occupational therapy with mental imagery), daily life habits are measured using the life habits questionnaire (H-Life). Then, the work performance priorities of the samples in the three areas of productivity, self-care and leisure time are determined using the Canadian Work Performance Scale (COPM), and the intervention should be carried out on these priorities. Clients perform their priority functions with the healthy side and using video rotation software, the prepared video is returned and sent to the clients. In the video made, it seems that the person with the involved side is doing an activity, and the video contains 5 functions that are a priority for the reference, and the duration of the video for each function is one minute (5 minutes in total). . Clients should view this video of priority functions before performing the visualization. which later visualizes these priority functions during the therapy session. Intervention protocol: 1- Mental imagery intervention for the intervention group: Mental imagery includes three parts: relaxation, imagination (visualization of prioritized functions) and normalization. The relaxation part (three minutes), fantasy or visualization of priority functions (5 minutes) and normalization (two minutes), which are 10 minutes in total. Mental imagery exercises are performed three times a day (for a total of 30 minutes), 3 times a week for 4 weeks. In all parts, the person should sit in a relaxed and comfortable position (the environment should have minimal noise and distractions). The first part of relaxation: relaxation; It includes three stages of breathing exercises, visualization of a relaxing environment and muscle relaxation. The whole relaxation part lasts for 3 minutes. The first stage of sedation or respiratory sedation; The person is asked to count to 4 and inhale through the nose while counting and then hold his breath and count to 4, then while breathing out to count to 4, finally without breathing again or Exhale for a count of 4 and repeat this process for 25 seconds. The second stage of relaxation; Imagining a relaxing environment: In this step, the person is asked to create a relaxing environment by remembering a relaxing environment or through imagination (for example, a day at the beach or in the forest). The elements of the environment using each of the five senses using commands such as: What do you see? (for example, the blue color of water), . what do you hear (eg waves crashing along the shore), what do you smell? (For example, the fruity scent of sunscreen), what do you smell? (eg, salty sea air), how do you feel? (for example, the heat of the sun). In total, this stage of relaxation takes 50 seconds. The third stage of relaxation; It is muscle relaxation, which consists of 6 steps and includes the following exercises: 1. Starting from the foot, bend the toes under and contract the leg muscles. Hold for 5 seconds, then slowly release for 10 seconds. 2. Contract the calf muscles. Hold for 5 seconds, then release slowly for 10 seconds. 3. Contract the buttock muscles. Hold for 5 seconds, then slowly release for 10 seconds. 4. Contract the abdominal and chest muscles. Hold for 5 seconds, then slowly release for 10 seconds. 5. Contract the shoulder muscles. Hold for 5 seconds, then release slowly for 10 seconds. 6. Contract the muscles of the face (for example, squeeze the eyes). Hold for 5 seconds, then slowly release for 10 seconds. 7. Contract the hand muscles and make a fist. Hold for 5 seconds, then slowly release for 10 seconds. A total of 105 seconds are spent on relaxing the muscles. Second part: imagining and visualizing priority functions; In this section, the references visualize the video made of the priority functions, the duration of which is 5 minutes, and one minute of visualization is considered for each function. The third part: normalization; in this stage, the client is asked to pay attention to the surrounding environment and the real position of his body, and the duration of this stage is 2 minutes. In total, it takes 10 minutes to complete all the mental imaging sections. Therefore, in every session that the client intends to visualize, he must repeat it 3 times a day, which takes a total of 30 minutes of visualization. 2- Routine occupational therapy intervention for the intervention group: Routine occupational therapy includes; Upper body exercises for 15 minutes: carrying a cube, pegboard, holding a cup and sliding objects on the table. Also, 15 minutes of exercises for the lower body: changing from sitting to standing, reaching sitting positions, walking and crossing obstacles, turning and transferring), 30 minutes per session, 3 times a week for 4 weeks. Takes. Control group: Includes routine occupational therapy, which includes upper extremity exercises for 15 minutes: carrying a cube, pegboard, holding a cup, and sliding objects on a table. Also, 15 minutes of exercises for the lower body: changing from sitting to standing, reaching sitting positions, walking and crossing obstacles, turning and transferring), 30 minutes per session, 3 times a week for 4 weeks. Takes. The score of daily life habits in the life habit(H-LIFE) questionnaire. Timepoint: The time periods of measuring life habits for the samples are done two weeks before the intervention and two weeks after the intervention. Method of measurement: Life habits(H-LIFE) questionnaires. Occupational performance score in the Canadian Occupational Performance measure(COPM). Timepoint: Occupational performance measurements for the samples are performed two weeks before the intervention and two weeks after the intervention. Method of measurement: Canadian Occupational Performance Measure(COPM). Tehran University of Medical Sciences Approved 2022-05-29 Ethics Committee of Tehran University of Medical Sciences Tehran, Enghelab St., Pich Shemiran, corner of Safi Alishah St., School of Rehabilitation Tehran Tehran Iran (Islamic Republic of)