Home-based motor imagery training for gait rehabilitation of people with chronic poststroke hemiparesis.
OBJECTIVE
To test the feasibility and efficacy of a home-based motor imagery gait training program to improve walking performance of individuals with chronic poststroke hemiparesis.


METHODS
Nonrandomized controlled trial.


METHODS
Local facility.


METHODS
Participants (N=17) were community-dwelling volunteers with hemiparesis caused by a unilateral stroke that occurred at least 3 months before the study.


METHODS
Participants received 15 minutes of supervised imagery gait training in their homes 3 days a week for 6 weeks. The intervention addressed gait impairments of the affected lower limb and task-specific gait training. Walking ability was evaluated by kinematics and functional scales twice before the intervention, 3 and 6 weeks after the intervention began, and at the 3-week follow-up.


METHODS
Spatiotemporal, kinematic, and functional walking measurements.


RESULTS
Walking speed increased significantly by 40% after training, and the gains were largely maintained at the 3-week follow-up. The effect size of the intervention on walking speed was moderate (.64). There were significant increases in stride length, cadence, and single-support time of the affected lower limb, whereas double-support time was decreased. Improvements were also noted on the gait scale of the Tinetti Performance-Oriented Mobility Assessment as well as in functional gait. Sixty-five percent of the participants advanced 1 walking category in the Modified Functional Walking Categories Index.


CONCLUSIONS
Although further study is recommended, the findings support the feasibility and justify the incorporation of home-based motor imagery exercises to improve walking skills for poststroke hemiparesis.
Dunsky
Ayelet
A
The Zinman College of Physical Education and Sport Sciences, Wingate Institute, Netanya, Israel. ayelet@wincol.ac.il
Dickstein
Ruth
R
Marcovitz
Emanuel
E
Levy
Sandra
S
Deutsch
Judith E
JE
Deutsch
Judith
J
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000843:Ankle Joint / Q000503:physiopathology; D001696:Biomechanical Phenomena; D002908:Chronic Disease; D004185:Disability Evaluation; D005240:Feasibility Studies; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000534:rehabilitation*; D006699:Home Care Services; D006801:Humans; D019018:Imagery, Psychotherapy / Q000379:methods*; D007719:Knee Joint / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000209:etiology / Q000534:rehabilitation*; D016059:Range of Motion, Articular; D020127:Recovery of Function; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation