Mental Practice with Inverse Video Presentation in Combination with Functional Electrical Stimulation for Upper Limb Paralysis: A Single-Case Study

Abstract

Objective: To investigate mental practice (MP) with inverse video in combination with functional electrical stimulation in a patient with left-sided hemiplegia with severe upper limb paralysis using a single-case design.

Methods: In a single case, the total intervention period for the ABA approach was 9 weeks. The participants were patients with stroke and motor paralysis in their upper extremities who could perform MP, and those who consented to the intervention study were recruited. The duration of each phase was 3 weeks, and each session lasted for 60 min/day. Neuromuscular stimulation and peg manipulation, among others, were performed in period A, while MP was performed using inverse video and functional electrical stimulation in period B. The effectiveness of the ABA approach was analyzed using the 2-standard deviation (2-SD) band method.

Results: The mean values of each efficacy index in period B were as follows: Fugl–Meyer Assessment-upper extremity, 50.3; Motor Activity Log (Amount of Use subscale), 3.8 and Motor Activity Log (Quality of Movement subscale), 3.8; and Action Research Arm Test (left), 44.0, which were higher than the mean + 2-SD values in period A. Furthermore, a significant improvement was observed in the paralyzed upper limb with the application of the integrated volitional control electrical stimulator (IVES) plus MP intervention using inverted video.

Conclusion: The synergistic effect of IVES and MP intervention using laterally inverted video resulted in an improvement in the function of the paralyzed upper limb.