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.