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

OBJECTIVE: 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.

DESIGN: A series of single-case studies.

SETTING: A stroke rehabilitation unit in Belfast.

SUBJECTS: Fourteen patients admitted for rehabilitation of their first stroke: six men and four women, aged 45-81 between 10 and 176 days post stroke.

INTERVENTION: 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.

MAIN OUTCOME MEASURES: The upper limb component of the Motricity Index was used to grade motor activity sequentially across the timescale of the study.

RESULTS: 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.

CONCLUSIONS: This pilot study suggests that mental practice may be useful as an adjunct to physiotherapy after stroke.