Date Presented 03/27/20
Both mental practice and action observation are portable, easy to use, efficacious interventions shown to improve arm and hand function poststroke. We combined these no-cost interventions and found that they are even more effective when combined than when administered separately. This is a significant advancement for OT practitioners, proving efficacy of an inexpensive regimen that combines two promising interventions to significantly increase poststroke hand function.
Primary Author and Speaker: Stephen Page
PURPOSE: To compare the effect of a multimodal mental practice (MMMP) regimen to a repetitive-task practice (RTP) only regimen on paretic upper extremity (UE) functional limitation.
DESIGN: Randomized, single-blinded, pre-post test design
METHOD: This study enrolled persons (n = 18) who experienced a stroke > 3 months prior to study enrollment and presented with moderate, stable UE impairment.. All participants were administered The Action Research Arm Test (ARAT); the UE section of the Fugl-Meyer Scale (FM); and the hand subscale of the Stroke Impact Scale (SIS), version 3.0 one week before and one week after intervention. Interventions: All subjects participated in their assigned intervention group 3x/week for a 10 week duration. Subjects in the RTP-only group participated in one-on-one UE training sessions, practicing 5 common UE activities for 45-minute sessions. Subjects in the MMMP group completed 45-minute UE training sessions consisting of action observation (AO), RTP, and mental practice (MP) activities each delivered in 15-minute increments.
RESULTS: Upon post-testing, participants in the MMMP group presented with statistically significant (p < .01) increases compared to the RTP-only group, surpassing the minimally clinically important difference standards for all three UE outcome measures.
CONCLUSIONS: Impact Statement: MMMP is more efficacious than the current standard of care for post-stroke UE weakness. Moreover, due to the time-matched duration of MMMP compared to RTP, findings suggest that MMMP may be just as feasible to implement in clinical settings that currently utilize RTP. Further efforts to replicate the results of this pilot study in a larger-scale clinical trial are warranted
References
Peters, H.T., & Page, S.J. (2015). Integrating Mental Practice with Task-specific Training and Behavioral Supports in Poststroke Rehabilitation: Evidence.Physical Medicine and Rehabilitation Clinics of North America, 26(4):: 715-727.. doi: 10.1016/j.pmr.2015.06.004.
Mizuguchi, N., & Kanosue K. Changes in brain activity during action observation and motor imagery: Their relationship with motor learning. Progress in Brain Research, 234:189-204. doi: 10.1016/bs.pbr.2017.08.008
