A strategy for computer-assisted mental practice in stroke rehabilitation.
OBJECTIVE
To investigate the technical and clinical viability of using computer-facilitated mental practice in the rehabilitation of upper-limb hemiparesis following stroke.


METHODS
A single-case study.


METHODS
Academic-affiliated rehabilitation center.


METHODS
A 46-year-old man with stable motor deficit of the upper right limb following subcortical ischemic stroke.


METHODS
Three computer-enhanced mental practice sessions per week at the rehabilitation center, in addition to usual physical therapy. A custom-made virtual reality system equipped with arm-tracking sensors was used to guide mental practice. The system was designed to superimpose over the (unseen) paretic arm a virtual reconstruction of the movement registered from the nonparetic arm. The laboratory intervention was followed by a 1-month home-rehabilitation program, making use of a portable display device.


METHODS
Pretreatment and posttreatment clinical assessment measures were the upper-extremity scale of the Fugl-Meyer Assessment of Sensorimotor Impairment and the Action Research Arm Test. Performance of the affected arm was evaluated using the healthy arm as the control condition.


RESULTS
The patient's paretic limb improved after the first phase of intervention, with modest increases after home rehabilitation, as indicated by functional assessment scores and sensors data.


CONCLUSIONS
Results suggest that technology-supported mental training is a feasible and potentially effective approach for improving motor skills after stroke.
Gaggioli
Andrea
A
Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Milan, Italy. andrea.gaggioli@auxologico.it
Meneghini
Andrea
A
Morganti
Francesca
F
Alcaniz
Mariano
M
Riva
Giuseppe
G
D001132:Arm / Q000503:physiopathology; D001921:Brain / Q000502:physiology; D003200:Computer User Training / Q000379:methods; D003201:Computers / Q000639:trends; D006801:Humans; D019018:Imagery, Psychotherapy / Q000295:instrumentation / Q000379:methods* / Q000639:trends; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology; D009415:Nerve Net / Q000502:physiology; D010291:Paresis / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D026741:Physical Therapy Modalities / Q000639:trends; D011597:Psychomotor Performance / Q000502:physiology*; D012046:Rehabilitation / Q000379:methods* / Q000523:psychology; D013028:Space Perception / Q000502:physiology; D020521:Stroke / Q000503:physiopathology / Q000523:psychology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D014584:User-Computer Interface