| Objective: To observe the effect and possible mechanism of intensive motor imagery therapy on the recovery of gait in hemiplegic stroke patients by using semi-quantitative analysis of regional cerebral blood flow (rCBF) through single photon emission computed tomography (SPECT). Methods: Five healthy cases served as control group. Thirty patients with hemiplegia after stroke were randomly divided into basic motor imagery group, which was treated with gait motor imagery (group A); and intensive motor imagery group, which was treated with gait intensive motor imagery (group B) (n=15 each). SPECT was used to observe the changes of cerebral blood flow (rCBF). Before and after treatment, Fugl-Meyer motor assessment (FMA) for the lower extremity, maximum walking speed (MWS) and Berg Balance Scale (BBS) were assessed. Results: Both control group and stroke group activated primary motor area, supplementary motor area and parietal lobe. As compared with the control group, activated center of stroke patients after motor imagery training was mainly to contralateral primary sensory area (S1), ipsilateral primary motor area (M1), ipsilateral supplementary motor area (SMA) and associated posterior parietal lobe. The regional rCBF in the cortex was significantly improved in both two groups (P<0.05), but there was no significant difference between the two groups after treatment (P>0.05). Before treatment, there was no significant difference in FMA, MWS or BBS scores between the two groups (P>0.05). After treatment, all the scores of lower limb function were improved (P<0.05), and MWS and BBS improvement was significantly greater in group B than in group A (P<0.05), but there was no significant difference in FMA scores between the two groups (P>0.05). Conclusion: The gait intensive motor imagery therapy could more effectively improve lower extremity motor function and gait than the basic motor imagery therapy, possibly by promoting the reorganization of brain function. Gait intensive motor imagery therapy is an effective method for the recovery of lower extremity motor function in hemiplegic stroke patients. |
