Investigating the Viability of Motor Imagery as a Physical Rehabilitation Treatment for Patients With Stroke-Induced Motor Cortical Damage

Abstract

Although around 83% of individuals survive a stroke, they usually experience a significant loss in their motor execution (ME) capabilities due to their acquired cortical infarction. The loss of significant ME capabilities due to stroke damage was previously thought to be irreversible. Active movement therapies show considerable promise but depend on motor performance, excluding many otherwise eligible patients. Motor imagery (MI), a process that involves the use of mirror neurons to imagine motor activity, has emerged as a possible avenue to re-acquire some physical abilities lost to stroke damage. This paper examines previous studies to compare the strength of brain activation and connectivity in individuals who have brain lesions and those who do not as they all attempt ME and MI tasks. This paper reviews case studies investigating the direct effect of motor imagery in conjunction with physical therapy and the limitations of motor imagery based on the location of cortical damage and other variables, such as age. The findings analyzed in this review indicate that MI would serve as a beneficial addition to physical therapy and a viable option to stimulate motor evoked potentials (MEPs) in individuals not capable of pursuing physical therapy due to severe motor impairment. Regardless of the presence of brain lesions, motor imagery has consistently had a positive impact on motor rehabilitation either in boosting treatment or stimulating neuromuscular pathways. Therefore, we have concluded that MI is a viable supplemental treatment plan for motor recovery in most patients with motor cortical atrophy.

Motor Imagery and Mental Practice in the Subacute and Chronic Phases in Upper Limb Rehabilitation after Stroke: A Systematic Review

“…These techniques are based on the theory of mirror neurons and demonstrate that people can produce plastic changes in the functionality of hand movements. Several studies have identified patterns in brain activation that occur during MI and found that MI largely activates regions including the frontoparietal network, subcortical and cerebellar regions, anterior intraparietal cortex, primary motor cortex (M1), bilateral supplementary area (SMA), and premotor area (PMA) [12]. Another study [13] showed that the use of MI improves a patient's upper limb motor functions and activation areas mentioned in the previous study.…”

Emerging Limb Rehabilitation Therapy After Post-stroke Motor Recovery

“…Therefore, regions within the primary motor cortex, cerebellum, and basal ganglia circuits can be activated during MI ( Kraft et al, 2015 ; Tong et al, 2017 ). In addition, MI can also induce the functional redistribution and regulation of neural circuits, remodeling the brain neural networks, and improving motor function relearning ability ( de Vries and Mulder, 2007 ; Gowda et al, 2021 ). Furthermore, repeated training can form a normal motor reflex arc, thus, promoting limb function recovery in the stroke patients ( Grabherr et al, 2015 ; López et al, 2019 ; Ladda et al, 2021 ).…”

Objectivizing Measures of Post-Stroke Hand Rehabilitation through Multi-Disciplinary Scales

“…This causes abnormal involuntary coupling between shoulder visitation and wrist/finger flexion (flexion synergy), as well as weakness in the muscles that are the extensors of the distal joints. This results in a significant limitation of hand opening movement [41,42].…”