title: Mental practice as a gateway to modified constraint-induced movement therapy: a promising combination to improve function.
abstract: Modified constraint-induced movement therapy (mCIMT) is a reimbursable regimen that improves the use and function of more-affected arms in patients who have had a stroke. To participate in this regimen, however, patients must exhibit active extension of the more-affected wrists and fingers, which renders many people ineligible. This study determined the efficacy of a mental practice program that preceded mCIMT in improving more-affected arm function in 4 patients with a stroke. Patients received therapy emphasizing activities of daily living (ADLs), followed by sessions of mental practice of the ADL. One week after completing mental practice, patients participated in mCIMT. After mental practice, patients exhibited marked changes on assessments and increased active wrist and finger extension, which qualified them for mCIMT. After mCIMT, participants exhibited additional functional gains, sustained 3 months later. Data suggest that mental practice provides a pathway whereby patients can participate in mCIMT, realize additional gains, and again perform valued ADLs.
authors.affiliation: University of Cincinnati Academic Medical Center, Department of Rehabilitation Sciences, University of Cincinnati, 3202 Eden Avenue, Suite 275, Cincinnati, OH 45267-0394, USA. Stephen.Page@uc.edu
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Page
authors.forename: Peter
authors.initials: P
authors.lastname: Levine
authors.forename: Valerie
authors.initials: V
authors.lastname: Hill
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D005260:Female; D005385:Fingers; D006801:Humans; D008297:Male; D008875:Middle Aged; D009788:Occupational Therapy / Q000379:methods; D026741:Physical Therapy Modalities / Q000523:psychology*; D020127:Recovery of Function / Q000502:physiology*; D000071939:Stroke Rehabilitation; D014953:Wrist