Effect of Tai Chi Yunshou motor imagery training on upper limb motor dysfunction with stroke patients

Upper limb motor dysfunction is common among stroke patients. Motor imagery, as a non-invasive brain training method, has gained increasing attention and application in stroke rehabilitation. However, there is currently limited research comparing the effectiveness of different motor imagery interventions for upper limb function. This study was designed to compare the effects of Tai Chi Yunshou motor imagery training and upper limb multi-joint linkage motor imagery training in stroke patients. This study is an assessor blinding, parallel-design, simple randomized controlled trial. 70 stroke patients who had a recovery period from 2 weeks to 6 months were recruited from a rehabilitative inpatient unit and then were randomly (enrolled from September 25, 2022, to February 1, 2023). Participants were randomized to undergo Tai Chi Yunshou motor imagery training combined with conventional rehabilitation training (n = 35) or upper limb multi-joint linkage motor imagery training combined with conventional rehabilitation training (n = 35). Each group received 6 sessions per week, for 3 weeks. The primary outcome was the Fugl-Meyer Assessment for Upper Extremity at week 3, with higher scores indicating better motor function. The secondary outcomes included the Brunnstrom Assessment, Modified Barthel Index, Modified Ashworth Scale, grip strength, pinch strength, and the Functional Test for the Hemiplegic Upper Extremity (Hong Kong version). Among the 70 randomized participants (mean [SD] age, 64.3 [9.2] years), 66 participants (mean [SD] age, 64.5 [8.7] years) completed 3 weeks in the study. At week 3, both groups showed improvement in daily living activities, motor recovery, and upper limb function. The intervention group had a greater decrease in the Fugl-Meyer Assessment for Upper Extremity (10.97 scores) than the control group with a mean difference of 3.88 scores (95% CI, 2.64 to 5.11; P < 0.001). Among stroke patients in a recovery period, the Tai Chi Yunshou motor imagery training, compared with the upper limb multi-joint linkage motor imagery training, resulted in better motor function after 3 weeks. Further studies are required to explore the underlying mechanisms of the intervention. This trial was registered in the China Clinical Trials Registry on 19 September 2022 (registration number: ChiCTR2200063876, http://www.chictr.org/cn/).