Retention of Motor Changes in Chronic Stroke Survivors Who Were Administered Mental Practice

Abstract

Page SJ, Murray C, Hermann V, Levine P. Retention of motor changes in chronic stroke survivors who were administered mental practice. Objective To determine retention of motor changes 3 months after participation in a regimen consisting of mental practice (MP) combined with repetitive task-specific (RTP) practice. Design Prospective, blinded, cohort, pre-post study. Setting Outpatient rehabilitation hospital. Participants Individuals (N=21) in the chronic stage of stroke (mean age ± SD, 66.1±8.1y; age range, 56–76y; mean time since stroke at study enrollment, 58.7mo; range, 13–129mo) exhibiting mild to moderate impairments of hand function. Interventions All individuals had been randomly assigned to receive a 10-week regimen consisting of MP emphasizing paretic upper extremity (UE) use during valued activities. Directly after each of these sessions, subjects were administered audiotaped MP. We assessed this group's paretic UE motor levels before, after, and 3 months after intervention. Main Outcome Measures The UE section of the Fugl-Meyer Assessment of Sensorimotor Impairment (FM), the Action Research Arm Test (ARAT), the Arm Motor Ability Test (AMAT), and the Box and Block Test (BB). Results None of the scores significantly changed from the period directly after intervention to the 3-month posttesting period (FM: t=.817; ARAT: t=.923; AMAT: t=.898, t=.818, and t=.967 for the Functional Ability, Quality of Movement, and Time scales, respectively; BB: t=.892). Conclusions Changes in paretic UE movement realized through MP combined with RTP (MP + RTP) participation are retained 3 months after the intervention has concluded. This is the first study examining retention of motor changes after MP + RTP participation, and one of only a few studies examining long retention of motor changes after any intervention targeting stroke-induced hemiparesis.