This study aims to investigate the relationship between motor imagery skills and neglect level, upper extremity motor function, activities of daily living, quality of life, lateralization performance, and mental timer performance in individuals with stroke. Individuals with stroke who meet the inclusion criteria and voluntarily agree to participate will be evaluated. Demographic and clinical information of the participants will be recorded on an assessment form prepared by the researcher. Upper extremity motor functions will be assessed using the Fugl-Meyer Upper Extremity Motor Assessment Scale and the Wolf Motor Function Test; activities of daily living will be assessed using the Modified Barthel Index; and quality of life will be assessed using the Stroke-Specific Quality of Life Scale. Motor imagery skills will be measured using the Kinesthetic and Visual Imagery Questionnaire and a mental timer task; upper extremity lateralization performance will be assessed using the Recognise™ application. Neglect level will be assessed using the Catherine Bergego Scale, the Line Splitting Test, and the Star Erase Test. The data obtained will be statistically analyzed to examine the relationships between motor imagery skills and other clinical variables.
Individuals who have experienced hemiplegia after an ischemic stroke,
who actively use their right extremity according to the Edinburgh Hand Preference Questionnaire,
who have right hemisphere involvement,
who are 18 years of age or older,
Individuals with major neurological, orthopedic, or rheumatological disorders affecting upper extremity function other than stroke (Polyneuropathy, Parkinson's Disease, Multiple Sclerosis, Rheumatoid Arthritis, etc.),
Individuals with upper extremity amputation,
Individuals with uncontrolled arrhythmia, uncontrolled hypertension, or unstable cardiac conditions,
Individuals with active malignancy and receiving related chemo/radiotherapy,
The study population consists of stroke patients residing in Malatya province, and the sample comprises patients who have presented to a specialist physician with this complaint, received a stroke diagnosis, and applied to our clinic. Patients who consult a physical medicine and rehabilitation specialist, have no contraindications indicated by the physician, voluntarily agree to participate in the study, and meet the study criteria will be randomly selected.
Cohort
Prospective
No intervention will be made; an assessment will be conducted.
Other interventionNo intervention will be made; an assessment will be conducted.
Fugl-Meyer Upper Extremity Motor Assessment Scale
Fugl-Meyer and colleagues developed the Fugl-Meyer Motor Assessment Scale in 1975 by expanding on Brunnstrom's motor assessment method. The scale is a widely used, reliable, and valid test for assessing paretic upper extremity motor impairment in stroke patients. The FM-UE is a 33-item sub-section of this scale. The scale evaluates the movement, coordination, and reflexes of the shoulder, elbow, forearm, wrist, and fingers. Each parameter is scored between 0 and 2 points, with a maximum score of 66, indicating good motor function. In tests evaluating upper extremity movement, the scoring is as follows: 0: movement cannot be performed, 1: movement is partially performed, and 2: movement is performed normally.
Kinesthetic and Visual Imagination Questionnaire (KVIQ)
The KGIA will be used to evaluate motor imagery skills. The Turkish validity and reliability study of the scale developed by Malouin et al. was conducted by Dilek et al. The questionnaire, administered with the assistance of an evaluator, consists of 10 movements and assesses how well participants can visualize and feel the movements. Participants are first asked to perform the movement actually, and then to visually and kinesthetically imagine the same movement. The level of visual and kinesthetic imagery is scored between 1 (no image/feeling) and 5 (very clear/very intense), and visual and kinesthetic imagery scores are calculated at the end of the evaluation.
Catherine Bergego Scale
It is a scale that assesses neglect syndrome by directly observing daily life. The 10-item scale was developed by Professor Philippe Azouvi (1996). The Turkish validity and reliability study was done by Kulaç et al.
Line Bisection Test
The line-splitting test is one of the tests used in the clinical diagnosis of neglect syndrome. In this test, patients are presented with a sheet of paper printed on A4 paper, consisting of straight horizontal lines of varying lengths. These lines are positioned in the center, to the right, and to the left of the paper. The paper is placed in front of the patient, in the midline. In this test, the patient is asked to mark the midpoint of all the lines on the paper. Patients with neglect often mark the right side of the original center.
Lateralization Assessment
Upper extremity right/left lateralization performance will be evaluated using the "Recognise™" application developed by the Neuro-Orthopaedic Institute. The "Recognise™ Hand" and "Recognise™ Shoulder" sections, specifically the "Vanilla" version of these sections, will be used. A total of 20 shoulder and 20 hand images will be displayed for 5 seconds, and participants will be asked to press the right or left button on the screen as accurately and quickly as possible, without focusing on their extremity. Participants will be allowed to practice before the actual assessment. Accuracy rates and reaction times will be recorded.
Mental Cronometre Time
This will be used to evaluate the chronometric aspect of motor imagery. A towel folding task will be given for the mental timer. First, the motor imagery task will be performed. The time displayed on the screen will be recorded by the observer. For the physical phase of the test, the same procedure will be performed and the time recorded using a timer. The mental timer ratio will be calculated.
Stroke-Specific Quality of Life Scale
The Quality of Life Assessment Scale (QQS), developed by Williams et al. in 1999, consists of 49 items covering 12 subcategories (mobility, fitness, upper extremity functionality, work/productivity, mood, self-care, social roles, family roles, language, vision, thinking, and personality) that assess the quality of life of individuals with stroke. The QQS is a 5-point Likert-type scale; the higher the total score (1=Strongly agree, 2=Partially agree, 3=Neither agree nor disagree, 4=Partially disagree, 5=Disagree), the better the quality of life of the stroke individual. The Turkish validity and reliability of the scale was established by Hakverdioğlu et al.
Modified Barthel Index
The Daily Living Independence Scale (DLI), used to measure individuals' independence in activities of daily living, is a modification of the Barthel Index. The DLI includes 10 items related to activities of daily living (eating, personal hygiene, bathing, dressing, bowel and bladder care, toilet use, ambulation, transfers, and stair climbing). Each item in the DLI has levels from 0 to 5. A different scoring system is used for each activity (for example, the scores for the eating sub-item are 0-2-5-8-10, while the scores for the transfer sub-item are 0-3-8-12-15). At level 1, the individual is unable to perform the activity, while at level 5, the individual can perform the activity unaided, albeit slowly. The total score ranges from 0 to 100. As the score increases, the individual's independence in activities of daily living increases. The DLI has good reliability and validity. The Turkish validity and reliability of the scale was established by Küçükdeveci et al.
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