title: Use of mental practice to improve upper-limb recovery after stroke: a systematic review.
abstract: OBJECTIVE
  We sought to determine whether mental practice is an effective intervention to improve upper-limb recovery after stroke.
  
  
  METHODS
  We conducted a systematic review of the literature, searching electronic databases for the years 1985 to February 2009. We selected studies according to specified criteria, rated each study for level of evidence, and summarized study elements.
  
  
  RESULTS
  Studies differed with respect to design, patient characteristics, intervention protocols, and outcome measures. All studies used imagery of tasks involving movement of the impaired limb. The length of the interventions and number of practice hours varied. Results suggest that mental practice combined with physical practice improves upper-limb recovery.
  
  
  CONCLUSIONS
  When added to physical practice, mental practice is an effective intervention. However, generalizations are difficult to make. Further research is warranted to determine who will benefit from training, the dosing needed, the most effective protocols, whether improvements are retained, and whether mental practice affects perceived occupational performance.
authors.affiliation: Teachers College, Columbia University, Box 199, 525 West 120th Street, New York, NY 10027-6696, USA. dmn12@columbia.edu
authors.forename: Dawn M
authors.initials: DM
authors.lastname: Nilsen
authors.forename: Glen
authors.initials: G
authors.lastname: Gillen
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Gordon
mesh_terms: D006801:Humans; D019018:Imagery, Psychotherapy; D020127:Recovery of Function; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D034941:Upper Extremity / Q000503:physiopathology*