Using motor imagery in the rehabilitation of hemiparesis.
OBJECTIVE
To examine the effectiveness of using motor imagery training in the rehabilitation of hemiparesis.


METHODS
A before-after trial with clinical and behavioral analyses of single cases.


METHODS
Academic-affiliated rehabilitation hospital.


METHODS
Two survivors of embolic middle cerebral artery stroke that resulted in chronic hemiparesis.


METHODS
A motor imagery training program consisting of imagined wrist movements (extension, pronation-supination) and mental simulations of reaching and object manipulation making use of a mirror box apparatus. Twelve 1-hour experimental sessions were delivered, 3 times a week for 4 consecutive weeks.


METHODS
Two clinical assessments, grip strength, 4 wrist functionality measurements, and 3 timed performance tests. All outcome measures were recorded before training began, at 3 times during the intervention month, with 2 additional long-term measurements.


RESULTS
Performance of the paretic limb improved after the imagery intervention, indicated by increases in assessment scores and functionality and decreases in movement times. The improvements over baseline performance remained stable over a 3-month period.


CONCLUSIONS
These results demonstrate the potential for using motor imagery as a cognitive strategy for functional recovery from hemiparesis. The intervention targets the cognitive level of action processing while its effects may be realized in overt behavioral performance.
Stevens
Jennifer A
JA
Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, IL 60611, USA. j-stevens3@northwestern.edu
Stoykov
Mary Ellen Phillips
ME
D000203:Activities of Daily Living; D000368:Aged; D002908:Chronic Disease; D003463:Cues; D005260:Female; D015577:Geriatric Assessment; D018737:Hand Strength; D006801:Humans; D019018:Imagery, Psychotherapy / Q000379:methods*; D020766:Intracranial Embolism / Q000150:complications; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D011403:Pronation; D011597:Psychomotor Performance; D020127:Recovery of Function; D013484:Supination; D013997:Time Factors; D016896:Treatment Outcome; D014953:Wrist / Q000503:physiopathology*