Mental Practice in Chronic Stroke

Abstract

Background and Purpose-Mental practice (MP) of a particular motor skill has repeatedly been shown to activate the same musculature and neural areas as physical practice of the skill. Pilot study results suggest that a rehabilitation program incorporating MP of valued motor skills in chronic stroke patients provides sufficient repetitive practice to increase affected arm use and function. This Phase 2 study compared efficacy of a rehabilitation program incorporating MP of specific arm movements to a placebo condition using randomized controlled methods and an appropriate sample size. Method-Thirty-two chronic stroke patients (meanϭ3.6 years) with moderate motor deficits received 30-minute therapy sessions occurring 2 days/week for 6 weeks, and emphasizing activities of daily living. Subjects randomly assigned to the experimental condition also received 30-minute MP sessions provided directly after therapy requiring daily MP of the activities of daily living; subjects assigned to the control group received the same amount of therapist interaction as the experimental group, and a sham intervention directly after therapy, consisting of relaxation. Outcomes were evaluated by a blinded rater using the Action Research Arm test and the upper extremity section of the Fugl-Meyer Assessment. Results-No pre-existing group differences were found on any demographic variable or movement scale. Subjects receiving MP showed significant reductions in affected arm impairment and significant increases in daily arm function (both at the PϽ0.0001 level). Only patients in the group receiving MP exhibited new ability to perform valued activities. Conclusions-The results support the efficacy of programs incorporating mental practice for rehabilitating affected arm motor function in patients with chronic stroke. These changes are clinically significant.

Clinical Assessment of Mental Rotation in Hemiplegic Patients after Stroke

“…In rehabilitation-related research, some studies have reported that physical function is improved by mental practice in stroke patients [2][3][4][5][6]19) ; however, our results showed that impaired motor imagery ability in the CVA group, suggesting that a strategy for therapeutic intervention with motor imagery is expected to have a high therapeutic effect because of the impaired attention of stroke patients. In the present study, the number of participants was too few to test reliability.…”

“…In humans, this type of injury strongly correlates with paralysis, sensory deficits, impairments in learning and memory, and disability in activities of daily living [ADL]; however, there are few effective therapies for the treatment of ischemic stroke 1) . Recent evidence suggests that the use of motor imagery training, as an additional therapy, has an effect on motor recovery after stroke [2][3][4][5][6] .…”

Effect of Mental Training on the Balance Control Ability of Healthy Subjects

“…In particular, balance dysfunction is a very important issue in the elderly. Numerous therapeutic interventions have been attempted in order to improve the postural control ability of elderly adults and various types of patients 6,8,9,30) . Our findings show that mental practice with motor imagery can provide an effective and safe training method for individuals with balance dysfunction.…”

“…Balance-related problems lead to considerable health problems and social incur services costs, because of the patient's dependence on basic functional activities 5) . In order to improve balance ability, many studies have adopted a wide range of training methods involving balance training with visual feedback, muscle strength training, plyometric, virtual reality, and mental training [6][7][8][9][10] .…”

A Comparison between Task Oriented and Client-Centred Task-Oriented Approaches to Improve Upper Limb Functioning in People with Sub-Acute Stroke

“…In Physiotherapy, a number of interventions studies have been published evaluating the effect of various rehabilitation methods in improving upper-extremity motor control and functioning [5][6][7][8][9][10][11][12][13][14][15][16][17].…”