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Mental practice in chronic stroke: results of a randomized, placebo-controlled trial.

18 Jan

Phase II research from Page and Levine at the University of Cincinnati shows further evidence of the efficacy of "mental practice" (kinesthetic or body-based guided imagery) for rehabilitation of arm movements after a stroke.

A research team from the Department of Physical Medicine and Rehabilitation at the University of Cincinnati College of Medicine completed a randomized, controlled study that compared the efficacy of a stroke rehabilitation program that incorporated "mental practice" (MP) or guided imagery of certain arm movements to a placebo condition.

Thirty-two chronic stroke patients (mean=3.6 years) with moderate motor deficits received 30-minute therapy sessions occurring 2 days/week for 6 weeks, and emphasizing activities of daily living. Subjects randomly assigned to the experimental condition also received 30-minute mental practice sessions provided directly after therapy, requiring daily practice during the week; subjects assigned to the control group received the same amount of therapist interaction as the experimental group, and a sham intervention directly after therapy, consisting of relaxation. Outcomes were evaluated by a blinded rater using the Action Research Arm test and the upper extremity section of the Fugl-Meyer Assessment.

With no pre-existing group differences found at the outset, the study found that those who received mental practice showed significant reductions in affected arm impairment, and significant increases in daily arm function (both at the P<0.0001 level). Additionally, only patients in the group receiving MP exhibited new ability to perform valued activities. The study affirms the efficacy of programs that incorporate mental practice for rehabilitating affected arm motor function in patients with chronic stroke, and concludes that these changes are clinically significant.

Citation: Page SJ, Levine P, Leonard A. Mental practice in chronic stroke: results of a randomized, placebo-controlled trial. Stroke. 2007 Apr; 38 (4):1293-7. Epub 2007 Mar 1. This email address is being protected from spambots. You need JavaScript enabled to view it.
Belleruth Naparstek

Psychotherapist, author and guided imagery pioneer Belleruth Naparstek is the creator of the popular Health Journeys guided imagery audio series. Her latest book on imagery and posttraumatic stress, Invisible Heroes: Survivors of Trauma and How They Heal (Bantam Dell), won the Spirituality & Health Top 50 Books Award