The adjunctive role of mental practice in the rehabilitation of the upper limb after hemiplegic stroke: a pilot study.

Abstract

To assess the feasibility and practicalities of using the technique of mental practice as an adjunct in the rehabilitation of the upper limb following stroke. A series of single-case studies. A stroke rehabilitation unit in Belfast. Fourteen patients admitted for rehabilitation of their first stroke: six men and four women, aged 45-81 between 10 and 176 days post stroke. Each patient underwent a single-case design, with two weeks baseline, two weeks intervention and one week withdrawal. The intervention consisted of structured daily mental practice sessions of a reach and grasp task, in addition to their usual therapy. The upper limb component of the Motricity Index was used to grade motor activity sequentially across the timescale of the study. Of the 14 patients recruited, four withdrew and 10 completed the study. Nine showed improvement in upper limb Motricity Index score with mental practice as measured by the two-band standard deviation method. One of these cases demonstrated an unstable baseline such that changes could not be attributed to intervention. This pilot study suggests that mental practice may be useful as an adjunct to physiotherapy after stroke.