Graded Motor ImageryNCT06326749
Effectiveness of Modified Graded Motor Imagery Training in Stroke Patients
A study testing Modified Graded Motor Imagery and Conventional Treatment Group, Graded Motor Imagery and Conventional Treatment Group and Conventional Treatment Group in people with Graded Motor Imagery and Stroke, run by Inonu University at 1 site in Turkey (Türkiye).
Trial summary
In the study, movement observation training, Modified Graded Motor Imaging Training, which includes upper extremity functional exercises, and Graded Motor Imaging Training, where the standard protocol is applied, will be used in stroke patients to improve their upper extremity motor functions and daily lives. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Graded Motor Imagery, Stroke, Action Observation Training
- What is being tested?
- Modified Graded Motor Imagery and Conventional Treatment Group, Graded Motor Imagery and Conventional Treatment Group and Conventional Treatment Group
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 46 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 15 Jun 2024to 30 Jul 2025
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Hemiplegia was observed after CVO, According to the Edinburgh Handedness Questionnaire, those who actively use their right extremity, Those with right hemisphere involvement, Being between the ages of 40 and 70, Having been diagnosed with stroke at least 1 month ago and at most 6 months ago, Middle cerebral artery involvement, Having a Standardized Mini Mental Test score of 24 or above, having a Stage 2b or above according to Eggers staging, Able to actively control hands, wrists and fingers and perform the release reflex Those who want to participate in the study voluntarily and Individuals with informed consent will be included in the study.
Who cannot join
- Those with major neurological, orthopedic or rheumatological disorders that affect upper extremity function other than stroke (Polyneuropathy, Parkinson's, Multiple Sclerosis, Rheumatoid Arthritis, etc.).
- Those with upper extremity amputation, Uncontrolled arrhythmia, uncontrolled hypertension, unstable cardiac status Active malignancy and receiving chemo/radiotherapy related to it Uncooperative due to aphasia or cognitive impairment Individuals with vision and hearing problems Having a communication problem that may prevent implementation of the evaluations and/or treatment program Individuals who do not allow mental evaluation, cannot fill out the scales, and are illiterate will not be included in the study.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Investigation of the Effect of Modified Graded Motor Imagery Training on Upper Extremity Motor Function, Activities of Daily Living, Quality of Life and Motor Imagery Skills in Stroke Patients
In the study, movement observation training, Modified Graded Motor Imaging Training, which includes upper extremity functional exercises, and Graded Motor Imaging Training, where the standard protocol is applied, will be used in stroke patients to improve their upper extremity motor functions and daily lives. It is aimed to present it on an evidence-based basis by investigating its effects on Daily Living Activity, quality of life, upper extremity-specific right/left lateralization performance, mental stopwatch performance and motor imagery skills.
Read the detailed description
At study is planned as a combination of action observation training, motor imagery and graded motor imagery training, which have come to the fore in recent years and whose importance increases with each passing year. Additionally, its preferability in treatment will be investigated by comparing it with Graded Motor Imagery training, in which the standard protocol is applied. It is anticipated that treatment protocols will shed light on future studies.
The hypotheses of the study are as follows:
Hypothesis 1: Modified Graded Motor Imagery training is more effective than Graded Motor Imagery training and conventional treatment in improving upper extremity motor functions in individuals with stroke.
Hypothesis 2: Modified Graded Motor Imagery training is more effective than Graded Motor Imagery training and conventional treatment in improving daily living activities in individuals with stroke.
Hypothesis 3: Modified Graded Motor Imagery training is more effective than Graded Motor Imagery training and conventional treatment in improving the quality of life in individuals with stroke.
Hypothesis 4: Modified Graded Motor Imagery training is more effective than Graded Motor Imagery training and conventional treatment in improving motor imagery skills in individuals with stroke. Design of the study: The study was designed as a randomized controlled study.
- Being tested
- Modified Graded Motor Imagery and Conventional Treatment Group, Graded Motor Imagery and Conventional Treatment Group, Conventional Treatment Group
- Keywords
- graded motor imagery, action observation training, Stroke, hemiplegia, upper limb function, activities of daily living, life quality
- Medical subject headings
- Stroke, Hemiplegia
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Modified Graded Motor Imagery and Conventional Treatment GroupOther
A modified form of graded motor imagery training and conventional rehabilitation will be applied.
Graded Motor Imagery and Conventional Treatment GroupOther
Graded motor imagery training and conventional rehabilitation will be applied.
Conventional Treatment GroupOther
conventional rehabilitation will be applied.
| Study group | Role | What they receive |
|---|---|---|
| Modified Graded Motor Imagery and Conventional Treatment Group: | Experimental | The modified DMI program consists of 4 stages: lateralization, open motor imagery including action observation training, mirror therapy and upper extremity functional exercise. The program will be implemented for 8 weeks, 3 days a week, under the supervision of a physiotherapist. Lateralization training will be applied in the first 2 weeks. Motor imagery training will be implemented in the 3rd and 4th weeks. For the second stage, the application will be combined with action observation training. As the 3rd stage, mirror therapy will be performed in the 5th and 6th weeks. The participant will be asked to perform some exercises while watching the reflection of the intact extremity in the mirror. In the final stage, they will be asked to physically perform upper extremity functional exercises. The total treatment time will be 40-50 minutes, with patients receiving 20-30 minutes of modified grade motor imagery and 20 minutes of conventional treatment. Receives: Other: Modified Graded Motor Imagery and Conventional Treatment Group |
| Graded Motor Imagery and Conventional Treatment Group: | Experimental | The DMI program consists of 3 stages: lateralization, open motor imagery and mirror therapy. The program will be implemented for 8 weeks, 3 days a week, under the supervision of a physiotherapist. First, lateralization training will be applied. In the second stage, motor imagery training will be applied. This phase will be carried out in a quiet environment by asking the participants to fully focus on the visualization of the movements. Two methods will be used for the imagined movements. In particular, visuals of the shoulder and hand used in the lateralization phase will be used to visualize movements related to the normal movement of the upper extremity. Participants will also be asked to imagine different activities in daily life. In the final stage, mirror therapy will be applied. The participant will be asked to perform some exercises while watching the reflection of the intact extremity in the mirror. Receives: Other: Graded Motor Imagery and Conventional Treatment Group |
| Conventional Treatment Group: | Experimental | Within the scope of the conventional treatment Bobath Method, facilitating movement and functional activities in the upper and lower extremities, activating trunk muscles, facilitating basic functional activities such as turning in bed, coming to sit and standing, improving weight bearing while sitting and standing, postural control, balance and walking. A targeted exercise program will be created. In line with this goal, upper and lower extremity exercises; don't turn around, don't come to sit, don't stand up; Exercises to activate core muscles; such as bridging, functional reaching; weight bearing and balance training; It is planned to implement walking training. Treatment time will be 40-50 minutes. Receives: Other: Conventional Treatment Group |
What is being measured
The primary outcome is the main question the study is designed to answer.
Fugl-Meyer Upper Extremity Motor Rating Scale
The scale is a widely used, reliable and valid test to evaluate paretic upper extremity motor impairment in stroke patients. From this scale, where each parameter is scored between 0-2 points, a maximum score of 66 can be obtained, and high scores indicate good motor functions.
Measured: before treatment, 2 months, 6 months
Wolf Motor Function Test (WMFT)
WMFT is used to evaluate motor skill in patients with upper extremity motor dysfunction. The 15 functional activities evaluated are scored between 0-5 points and the functional skill score is calculated by taking the average of the total score. Higher scores indicate better functional ability. In the performance time section, how long each activity took is recorded. A maximum of 120 seconds is allowed to complete an activity. If the activity cannot be completed within this time, the performance time is recorded as 120 seconds.
Measured: before treatment, 2 months, 6 months
Modified Barthel Index
MBI, which is used to measure the independence of individuals in daily living activities, emerged by modifying the Barthel Index. MBI includes 10 items related to activities of daily living. Total score is between 0-100. As the score increases, individuals' independence in daily living activities increases.
Measured: before treatment, 2 months, 6 months
Stroke-Specific Quality of Life Scale
It consists of a total of 49 items for 12 subcategories (mobility, fitness, upper extremity functionality, work/productivity, mood, self-care, social roles, family roles, language, vision, thinking and personality) that evaluate the quality of life of individuals with stroke. The higher the total score, the better the stroke individual's quality of life.
Measured: before treatment, 2 months, 6 months
Secondary outcomes (3)
Lateralization Assessment
Right/left lateralization performance of the upper extremity will be evaluated with the "Recognise™" application developed by the Neuro Orthapedic Institute. The "Recognise™ Hand" and "Recognise™ Shoulder" sections of this application and the "Vanilla" part of these sections will be used. Accuracy rates and reaction time in the application will be recorded. An increase in the accuracy rate indicates that lateralization performance has improved.
Measured: before treatment, 2 months, 6 months
Mental Chronometry Time
It will be used to evaluate the chronometric aspect of motor imagery. You will be given the task of wearing and folding a T-shirt for the mental stopwatch period.First, the motor imagery task will be performed. The time written on the screen is recorded by the observer. For the physical phase of the test, the same application is actually carried out and the time is recorded with the help of a stopwatch. Mental stopwatch rate will be calculated.
Mental stopwatch ratio = (Time in which the movement is physically performed - Time in which the movement is performed with imagination) / Time in which the movement is physically performed.
Measured: before treatment, 2 months, 6 months
Kinesthetic and Visual Imagery Questionnaire (KGIA)
CSIA will be used to evaluate motor imagery skills. After experiencing the movement in reality, he will be asked to imagine himself watching the same movement as if it were actually performed. Participants will evaluate the quality of the image in the visualization by giving points between 1 and 5, including "1 (no image)" and "5 (clear as the original)". An increase in the score indicates improvement.
Measured: before treatment, 2 months, 6 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted22 Mar 2024
- Study start15 Jun 2024
- Primary completion15 Jun 2025
- Study completion30 Jul 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Graded Motor ImageryStudies of the same condition, open and under way.
- More trials run by Inonu UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 46 participants (actual)
Sponsor and investigators
- Lead sponsor
- Inonu University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Havva Adlı, Hasan Kalyoncu University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06326749
- Sponsor's protocol ID
- 2024/19
- Status last verified
- Oct 2026
- First submitted
- 10 Mar 2024
- Last updated
- 27 Oct 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Braun N, Kranczioch C, Liepert J, Dettmers C, Zich C, Busching I, Debener S. Motor Imagery Impairment in Postacute Stroke Patients. Neural Plast. 2017;2017:4653256. doi: 10.1155/2017/4653256. Epub 2017 Mar 28.
PubMed 28458926Candiri B, Talu B, Guner E, Ozen M. The effect of graded motor imagery training on pain, functional performance, motor imagery skills, and kinesiophobia after total knee arthroplasty: randomized controlled trial. Korean J Pain. 2023 Jul 1;36(3):369-381. doi: 10.3344/kjp.23020. Epub 2023 Jun 22.
PubMed 37344366Yu JA, Park J. The effect of first-person perspective action observation training on upper extremity function and activity of daily living of chronic stroke patients. Brain Behav. 2022 May;12(5):e2565. doi: 10.1002/brb3.2565. Epub 2022 Apr 10.
PubMed 35398981
Study at a glance
From the registry record, last updated by the sponsor on 27 Oct 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Investigation of the Effect of Modified Graded Motor Imagery Training on Upper Extremity Motor Function, Activities of Daily Living, Quality of Life and Motor Imagery Skills in Stroke Patients
- ClinicalTrials.gov ID
- NCT06326749
- Acronym / sponsor ID
- 2024/19
- Keywords
- graded motor imagery, action observation training, Stroke, hemiplegia, upper limb function, activities of daily living, life quality
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 46 participants (actual)
- Lead sponsor
- Inonu UniversityUniversity, hospital or other
- Study start
- 15 Jun 2024 (actual)
- Primary completion
- 15 Jun 2025 (actual)
- Study completion
- 30 Jul 2025 (actual)
- First posted
- 22 Mar 2024 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
In the study, movement observation training, Modified Graded Motor Imaging Training, which includes upper extremity functional exercises, and Graded Motor Imaging Training, where the standard protocol is applied, will be used in stroke patients to improve their upper extremity motor functions and daily lives. It is aimed to present it on an evidence-based basis by investigating its effects on Daily Living Activity, quality of life, upper extremity-specific right/left lateralization performance, mental stopwatch performance and motor imagery skills.
Detailed description
At study is planned as a combination of action observation training, motor imagery and graded motor imagery training, which have come to the fore in recent years and whose importance increases with each passing year. Additionally, its preferability in treatment will be investigated by comparing it with Graded Motor Imagery training, in which the standard protocol is applied. It is anticipated that treatment protocols will shed light on future studies.
The hypotheses of the study are as follows:
Hypothesis 1: Modified Graded Motor Imagery training is more effective than Graded Motor Imagery training and conventional treatment in improving upper extremity motor functions in individuals with stroke.
Hypothesis 2: Modified Graded Motor Imagery training is more effective than Graded Motor Imagery training and conventional treatment in improving daily living activities in individuals with stroke.
Hypothesis 3: Modified Graded Motor Imagery training is more effective than Graded Motor Imagery training and conventional treatment in improving the quality of life in individuals with stroke.
Hypothesis 4: Modified Graded Motor Imagery training is more effective than Graded Motor Imagery training and conventional treatment in improving motor imagery skills in individuals with stroke. Design of the study: The study was designed as a randomized controlled study.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Modified Graded Motor Imagery and Conventional Treatment Group: | Experimental | Other: Modified Graded Motor Imagery and Conventional Treatment GroupThe modified DMI program consists of 4 stages: lateralization, open motor imagery including action observation training, mirror therapy and upper extremity functional exercise. The program will be implemented for 8 weeks, 3 days a week, under the supervision of a physiotherapist. Lateralization training will be applied in the first 2 weeks. Motor imagery training will be implemented in the 3rd and 4th weeks. For the second stage, the application will be combined with action observation training. As the 3rd stage, mirror therapy will be performed in the 5th and 6th weeks. The participant will be asked to perform some exercises while watching the reflection of the intact extremity in the mirror. In the final stage, they will be asked to physically perform upper extremity functional exercises. The total treatment time will be 40-50 minutes, with patients receiving 20-30 minutes of modified grade motor imagery and 20 minutes of conventional treatment. |
| Graded Motor Imagery and Conventional Treatment Group: | Experimental | Other: Graded Motor Imagery and Conventional Treatment GroupThe DMI program consists of 3 stages: lateralization, open motor imagery and mirror therapy. The program will be implemented for 8 weeks, 3 days a week, under the supervision of a physiotherapist. First, lateralization training will be applied. In the second stage, motor imagery training will be applied. This phase will be carried out in a quiet environment by asking the participants to fully focus on the visualization of the movements. Two methods will be used for the imagined movements. In particular, visuals of the shoulder and hand used in the lateralization phase will be used to visualize movements related to the normal movement of the upper extremity. Participants will also be asked to imagine different activities in daily life. In the final stage, mirror therapy will be applied. The participant will be asked to perform some exercises while watching the reflection of the intact extremity in the mirror. |
| Conventional Treatment Group: | Experimental | Other: Conventional Treatment GroupWithin the scope of the conventional treatment Bobath Method, facilitating movement and functional activities in the upper and lower extremities, activating trunk muscles, facilitating basic functional activities such as turning in bed, coming to sit and standing, improving weight bearing while sitting and standing, postural control, balance and walking. A targeted exercise program will be created. In line with this goal, upper and lower extremity exercises; don't turn around, don't come to sit, don't stand up; Exercises to activate core muscles; such as bridging, functional reaching; weight bearing and balance training; It is planned to implement walking training. Treatment time will be 40-50 minutes. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (1 listed)
- Hemiplegia was observed after CVO, According to the Edinburgh Handedness Questionnaire, those who actively use their right extremity, Those with right hemisphere involvement, Being between the ages of 40 and 70, Having been diagnosed with stroke at least 1 month ago and at most 6 months ago, Middle cerebral artery involvement, Having a Standardized Mini Mental Test score of 24 or above, having a Stage 2b or above according to Eggers staging, Able to actively control hands, wrists and fingers and perform the release reflex Those who want to participate in the study voluntarily and Individuals with informed consent will be included in the study.
Key exclusion criteria (2 listed)
- Those with major neurological, orthopedic or rheumatological disorders that affect upper extremity function other than stroke (Polyneuropathy, Parkinson's, Multiple Sclerosis, Rheumatoid Arthritis, etc.).
- Those with upper extremity amputation, Uncontrolled arrhythmia, uncontrolled hypertension, unstable cardiac status Active malignancy and receiving chemo/radiotherapy related to it Uncooperative due to aphasia or cognitive impairment Individuals with vision and hearing problems Having a communication problem that may prevent implementation of the evaluations and/or treatment program Individuals who do not allow mental evaluation, cannot fill out the scales, and are illiterate will not be included in the study.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Modified Graded Motor Imagery and Conventional Treatment GroupA modified form of graded motor imagery training and conventional rehabilitation will be applied. | Other | Modified Graded Motor Imagery and Conventional Treatment Group: |
| Graded Motor Imagery and Conventional Treatment GroupGraded motor imagery training and conventional rehabilitation will be applied. | Other | Graded Motor Imagery and Conventional Treatment Group: |
| Conventional Treatment Groupconventional rehabilitation will be applied. | Other | Conventional Treatment Group: |
Primary outcome
Fugl-Meyer Upper Extremity Motor Rating Scale
Time frame: before treatment, 2 months, 6 months
The scale is a widely used, reliable and valid test to evaluate paretic upper extremity motor impairment in stroke patients. From this scale, where each parameter is scored between 0-2 points, a maximum score of 66 can be obtained, and high scores indicate good motor functions.
Wolf Motor Function Test (WMFT)
Time frame: before treatment, 2 months, 6 months
WMFT is used to evaluate motor skill in patients with upper extremity motor dysfunction. The 15 functional activities evaluated are scored between 0-5 points and the functional skill score is calculated by taking the average of the total score. Higher scores indicate better functional ability. In the performance time section, how long each activity took is recorded. A maximum of 120 seconds is allowed to complete an activity. If the activity cannot be completed within this time, the performance time is recorded as 120 seconds.
Modified Barthel Index
Time frame: before treatment, 2 months, 6 months
MBI, which is used to measure the independence of individuals in daily living activities, emerged by modifying the Barthel Index. MBI includes 10 items related to activities of daily living. Total score is between 0-100. As the score increases, individuals' independence in daily living activities increases.
Stroke-Specific Quality of Life Scale
Time frame: before treatment, 2 months, 6 months
It consists of a total of 49 items for 12 subcategories (mobility, fitness, upper extremity functionality, work/productivity, mood, self-care, social roles, family roles, language, vision, thinking and personality) that evaluate the quality of life of individuals with stroke. The higher the total score, the better the stroke individual's quality of life.
3 secondary outcomes
Lateralization Assessment
Time frame: before treatment, 2 months, 6 months
Mental Chronometry Time
Time frame: before treatment, 2 months, 6 months
Kinesthetic and Visual Imagery Questionnaire (KGIA)
Time frame: before treatment, 2 months, 6 months
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 27 Oct 2026.
- Background: PubMed 28458926Braun N, Kranczioch C, Liepert J, Dettmers C, Zich C, Busching I, Debener S. Motor Imagery Impairment in Postacute Stroke Patients. Neural Plast. 2017;2017:4653256. doi: 10.1155/2017/4653256. Epub 2017 Mar 28.
- Background: PubMed 37344366Candiri B, Talu B, Guner E, Ozen M. The effect of graded motor imagery training on pain, functional performance, motor imagery skills, and kinesiophobia after total knee arthroplasty: randomized controlled trial. Korean J Pain. 2023 Jul 1;36(3):369-381. doi: 10.3344/kjp.23020. Epub 2023 Jun 22.
- Background: PubMed 35398981Yu JA, Park J. The effect of first-person perspective action observation training on upper extremity function and activity of daily living of chronic stroke patients. Brain Behav. 2022 May;12(5):e2565. doi: 10.1002/brb3.2565. Epub 2022 Apr 10.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Modified Graded Motor Imagery and Conventional Treatment Group, Graded Motor Imagery and Conventional Treatment Group and Conventional Treatment Group in people with Graded Motor Imagery and Stroke, run by Inonu University at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 27 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Fugl-Meyer Upper Extremity Motor Rating Scale (time frame: before treatment, 2 months, 6 months). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06326749, which also lists 3 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Oct 2026.