Audio-Guided Versus Video-Guided Mental Practice in Reducing Upper Extremity Hemiparesis

Abstract

<h3>Research Objectives</h3> To compare the effect of audio-guided mental practice (MP) and video-guided MP on impairment and functional abilities of upper extremity (UE) hemiparesis following stroke. <h3>Design</h3> Randomized controlled trial. Participants were randomly assigned: audio-guided MP, video-guided MP, repetitive task practice (RTP), or traditional therapy (control) groups. Baseline and post-intervention scores from outcome measures were compared. <h3>Setting</h3> Inpatient Rehabilitation Hospital. <h3>Participants</h3> Inclusion Criteria: ages 18-80, less than one month post stroke, moderate UE hemiparesis. Exclusion: history of prior stroke, severe pain, comorbidities, spasticity, aphasia or cognitive impairments, inability to perform MP, non-english speaking.18 participants completed the study, two participants were eligible and refused. <h3>Interventions</h3> MP groups performed MP five days a week (via video or audio guidance), of the following tasks: wiping a table, picking up a cup, brushing hair, and turning the pages of a book. The RTP group physically performed the same tasks. The control group received traditional stroke rehabilitation. <h3>Main Outcome Measures</h3> Wolf Motor Function Test (WMFT) and Fugl Meyer Assessment- Upper Extremity (FM). <h3>Results</h3> Wilcoxon signed-rank test demonstrated that audio MP increased FM scores from pre-test (Mdn = 34.0, Mean = 34.0, SD=9.56) to post-test (Mdn = 49.0, Mean = 49.6, SD=7.5), n=5, Z=2.03, p=.042, r=.91). Similar improvement in FM scores was found with traditional therapy. Audio MP also decreased WMFT time, pre-test (Mdn = 10.5, Mean = 49.9, SD=59.1) to post-test (Mdn = 4.1, Mean 3.5, SD = 1.4), Z=2.02, p=.043, r=.90. <h3>Conclusions</h3> Audio MP and traditional therapy appear to decrease impairment and increase the functional abilities of the UE following stroke. Video MP and RTP did not have this effect. These preliminary findings expand therapeutic options to existing occupational therapy practice in stroke rehabilitation. <h3>Author(s) Disclosures</h3> No conflict of interest.