Rehabilitation of the elbow extension with motor imagery in a patient with quadriplegia after tendon transfer.
OBJECTIVE
To test the effect of a postsurgical motor imagery program in the rehabilitation of a patient with quadriplegia.


METHODS
Crossover design with kinematic analysis.


METHODS
Rehabilitation Hospital of Lyon. Study approved by the local Human Research Ethics Committee.


METHODS
C6-level injured patient (American Spinal Injury Association Impairment Scale grade A) with no voluntary elbow extension (triceps brachialis score 1).


METHODS
The surgical procedure was to transfer the distal insertion of the biceps brachii onto the triceps tendon of both arms. The postsurgical intervention on the left arm included 10 sessions of physical rehabilitation followed by 10 motor imagery sessions of 30 minutes each. The patient underwent 5 sessions a week during 2 consecutive weeks. The motor imagery content included mental representations based on elbow extension involved in goal-directed movements. The rehabilitation period of the right arm was reversed, with motor imagery performed first, followed by physical therapy.


METHODS
The kinematics of upper-limb movements was recorded (movement time and variability) before and after each type of rehabilitation period. A long-term retention test was performed 1 month later.


RESULTS
Motor imagery training enhanced motor recovery by reducing hand trajectory variability-that is, improving smoothness. Motor performance then remained stable over 1 month.


CONCLUSIONS
Motor imagery improved motor recovery when associated with physical therapy, with motor performance remaining stable over the 1-month period. We concluded that motor imagery should be successfully associated with classic rehabilitation procedure after tendon transfer. Physical sessions may thus be shortened if too stressful or painful.
Grangeon
Murielle
M
Université de Lyon, Université Claude Bernard Lyon1, Centre de Recherche et d'Innovation sur le Sport, Equipe d'Accueil 647, Laboratoire de la Performance Motrice, Mentale et du Matériel, Villeurbanne Cedex, France.
Guillot
Aymeric
A
Sancho
Pierre-Olivier
PO
Picot
Marion
M
Revol
Patrice
P
Rode
Gilles
G
Collet
Christian
C
D000328:Adult; D001696:Biomechanical Phenomena; D018592:Cross-Over Studies; D004551:Elbow Joint; D006801:Humans; D019018:Imagery, Psychotherapy; D008297:Male; D026741:Physical Therapy Modalities; D011782:Quadriplegia / Q000209:etiology / Q000601:surgery*; D013119:Spinal Cord Injuries / Q000150:complications; D013709:Tendon Transfer / Q000534:rehabilitation*