ArticlesEffects of mental practice on affected limb use and function in chronic stroke
Section snippets
Participants
Subjects for this study were recruited as part of a larger MP study. We placed advertisements in therapy clinics and gave them to therapists in the midwestern United States. A research team member screened volunteers according to the following inclusion criteria: (1) 10° or more of active flexion in the more affected wrist, as well as in 2 digits of the more affected hand; (2) stroke experienced more than 1 year before study enrollment; (3) a score 70 or higher on the modified Mini-Mental
Results
Before the intervention, none of the subjects used their more affected upper limb for ADLs, as indicated by self-rated pretest mean AOU scores of 1.1 and 0.9 for the MP and control groups, respectively. The caregivers’ mean AOU ratings for the preintervention MAL closely corroborated patient estimates, with scores of 1.05 and 1.15 for MP and control groups, respectively. After the intervention, AOU ratings by MP patients and their caregivers were 2.60 and 2.71, respectively. Mean change scores
Discussion
Stroke patients often do not use their more affected arms for ADLs, even when they are capable of doing so. In addition to causing a greater handicap level, this nonuse can undermine motor return, because limb use appears to be related to cortical reorganization and, ultimately, to reacquisition of motor function. This case series examined MP as a strategy to increase use and function of the more affected limb after stroke.
The MAL AOU scores showed that all subjects not only met the criterion
Conclusions
MP appears to be a promising protocol for improving more affected upper-limb motor function in stroke patients. Our data also suggest that MP participation increases more affected limb use. These use patterns may be altered by demonstrating to patients that they are capable of performing more with the affected limb than they believed. It is also plausible that more affected limb use becomes more salient through MP use because new motor schema are developed, or preexisting motor schema are
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Supported by the Retirement Research Foundation (grant no. 2001-037).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.