Task-oriented “mental practices,” combined with traditional physical or occupational therapy, can improve upper-extremity function in patients recovering from subacute strokes, according to a multicenter, prospective, randomized clinical trial. Imagining movement, without physically acting, changes specific brain activity, said researcher Annick A.A. Timmermans, PhD, of the Maastricht University in the Netherlands and her colleagues. They compared 6 weeks of mental practice with traditional stroke therapy plus neurodevelopmental therapy, in which a patient is taught movements considered keys to recovery. The team recruited 42 patients from rehabilitation departments and randomized them to receive video-instructed mental practice three times a day or neurodevelopmental therapy and rehabilitation. The researchers measured improvement by patients' scores on Fugi-Meyer, Wolf Motor Function, and Frenchay Arm tests, as well as accelerometry. Only the patients using mental practice showed significant improvement on the Frenchay Arm test. Both groups showed improvements on the Fugi-Meyer and Wolf Motor Function tests and on accelerometry. “Persons after stroke do improve significantly on the skills they trained on with mental practice in addition to therapy as usual,” Dr. Timmermans said in an interview. “However, the modus, intensity, and frequency of training were not enough to find differential effects with training by means of exercises that are based on neurodevelopmental therapy.” “Mental practice is a promising intervention for persons after stroke,” but further research is needed, she added. Source: Effect of Mental Practice on the Improvement of Function and Daily Activity Performance of the Upper Extremity in Patients With Subacute Stroke: A Randomized Clinical Trial – A. Timmermans et al. After testing 10 ways to measure the quality of end-of-life care and the quality of dying in long-term care settings, researchers in the United States and the Netherlands recommended the End-of-Life in Dementia-Satisfaction with Care (EOLD-SWC) instrument for assessing care and the End-of-Life in Dementia-Comfort Assessment at Dying (EOLD-CAD) and the Mini-Suffering State Examination (MSSE) instruments for measuring quality of dying. The team, led by Mirjam C. van Soest-Poortvliet of the EMGO Institute for Health and Care Research, Amsterdam, had 264 families of deceased nursing home residents in the United States, and 70 families and 103 caregivers of deceased nursing home residents in the Netherlands complete interviews and questionnaires. The three assessment instruments were recommended because they best met the criteria that the researchers had established. “Our overview of measurement properties is unique in that it is the only available overview of the performance of end-of-life instruments in two parallel studies showing performance on feasibility, validity and reliability,” the researchers said. “This overview allows for comparison of instruments because we examined all instruments simultaneously in the same study population. Based on the measurement properties, we were able to recommend the best instruments to measure [quality of end-of-life care and quality of dying] using empirical, comparative data. This overview may also aid selecting an instrument for specific purposes.” Source: Selecting the Best Instruments to Measure Quality of End-of-Life Care and Quality of Dying in Long Term Care – M.C. van Soest-Poortvliet et al.