Category: Stroke; Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development)
Upper extremity rehabilitation after stroke is a big challenge to the rehabilitation professionals. Mental imagery is a cost-effective and clinically feasible intervention can be used to resolve the impairments and improve the quality of life after stroke.
In the present study, we identified the effect of three weeks of Mental Imagery intervention in improving the upper extremity function in chronic stroke patients. We hypothesized that the patients receiving Mental Imagery would improve the use of their affected upper extremities.
Design: Pre and post-test controlled Experimental design.
Setting : Community-dwelling chronic Stroke patients
Participants (or Animals, Specimens, Cadavers) : Participants: 30 chronic stroke patients with age of 40-60 years were included in the study. The volunteers were screened according to the following inclusion criteria: (1) Stroke experienced for more than one year before study enrolment (chronic stroke); (2) Age group of 40 to 60 years; (3) Only having experienced 1 stroke; (4) No excessive spasticity in the affected upper limb, defined as a score of 3 or lower on Modified Ashworth Scale; (5) A score of 20 or higher on Mini-Mental state examination.
Interventions : After signing the consent forms, the Fugl-Meyer Assessment and Motor Activity Log were administered. All patients received therapy in the same environment and from the same therapist. Subjects in the experimental group received physical practice of Activities of daily living (trained) prior to mental imagery for 15 minutes in each session, 4 days a week for 3 weeks. The Activities of daily living practiced by the subjects were chosen on the basis of the week of the treatment. Subjects in the control group received the same therapy regimen as those in the experimental group except mental imagery. Their therapist’s contact parameters were identical to those of experimental group subjects. Control subjects received conventional physiotherapy regimen for 15 minutes after the physical practice.
Main Outcome Measure(s) :
Motor Activity Log (Quality and Quantity of Movement) and Fugl-Meyer Assessment (Upper extremity section).
Subjects who received mental imagery showed improvements in Fugl-Meyer Assessment and Quality of Movement scores. However, no significant improvements were seen in Amount of Use scores. In contrast controls showed nominal increase of scores.
Conclusions : Participation in a mental Imagery protocol can improve the upper extremity function in chronic stroke patients.