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Research: PAGE and others,
Listed in Issue 148
Abstract
PAGE and others, Department of Physical Medicine and Rehabilitation, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0530, Stephen.Page@uc.edu, have conducted a randomized controlled trial of mental practice in stroke patients.
Background
Mental practice of a particular motor skill has repeatedly been shown to activate the same musculature and neural areas as physical practice of the skill. Pilot study results suggest that a rehabilitation program incorporating Mental Practice of valued motor skills in chronic stroke patients provides sufficient repetitive practice to increase affected arm use and function. The aim of this Phase 2 study was to compare the efficacy of a rehabilitation program incorporating Mental Practice of specific arm movements to a placebo condition.
Methodology
32 chronic stroke patients 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 Mental Practice of the activities of daily living; 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.
Results
Subjects receiving Mental Practice showed significant reductions in affected arm impairment and significant increases in daily arm function (both at the p < 0.0001 level). Only patients in the group receiving Mental Practice exhibited new ability to perform valued activities.
Conclusion
The results support the efficacy of programs incorporating mental practice for rehabilitating affected arm motor function in patients with chronic stroke. These changes are clinically significant.
References
Page SJ, Levine P, Leonard A. Mental practice in chronic stroke: results of a randomized, placebo-controlled trial. Stroke 38 (4): 1293-1297, Apr 2007.
Comment
Stroke afflicts considerable disability and misery upon patients. The results of this study, demonstrate that mental practice can improve limb function. It is hoped that these results are implemented into clinical practice.
