This is an exciting time for those working in the area of stroke rehabilitation. Our ability to base our interventions on evidence continues to evolve. The area of motor control training is receiving particular attention and a variety of techniques (both low tech and high tech) have been found to be effective. Over the next few weeks, I will review a variety of evidence based interventions that have been found to be effective with this population from both a practical and empirical perspective. This first review examines the evidence that supports the low tech intervention of mental practice.
Mental practice is a training method during which a person cognitively rehearses a physical skill using motor imagery in the absence of overt, physical movements for the purpose of enhancing motor skill performance. Nilsen, Gillen, and Gordon recently conducted a systematic review of the evidence that supports the use of this technique to improve upper limb function after stroke. The abstract follows:
OBJECTIVE. We sought to determine whether mental practice is an effective intervention to improve upper-limb recovery after stroke.
METHOD. We conducted a systematic review of the literature, searching electronic databases for the years 1985 to February 2009. We selected studies according to specified criteria, rated each study for level of evidence, and summarized study elements.
RESULTS. Studies differed with respect to design, patient characteristics, intervention protocols, and outcome measures. All studies used imagery of tasks involving movement of the impaired limb. The length of the interventions and number of practice hours varied. Results suggest that mental practice combined with physical practice improves upper-limb recovery.
CONCLUSION. When added to physical practice, mental practice is an effective intervention. However, generalizations are difficult to make. Further research is warranted to determine who will benefit from training, the dosing needed, the most effective protocols, whether improvements are retained, and whether mental practice affects perceived occupational performance.
Nilsen, D. M., Gillen, G., & Gordon, A. M. (2010). Use of mental practice to improve upper-limb recovery after stroke: A systematic review. American Journal of Occupational Therapy, 64, 695–708. doi: 10.5014/ajot.2010.09034
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