Mental practice to improve arm function and arm movement in individuals with hemiparesis after stroke

Moderate certainty is good enough for most patients and since this is a costless therapy, protocols should exist and be distributed to all 10 million yearly stroke survivors. That means someone has to create an information distribution platform to get this to all 10 million yearly stroke survivors  because our fucking failures of stroke associations haven't and obviously can't do it.  

• mental practice (8 posts to July 2015)

 

Mental practice to improve arm function and arm movement in individuals with hemiparesis after stroke

Review question
Does mental practice improve the outcomes of upper extremity rehabilitation for individuals living with the effects of stroke?
Background
Mental practice is a process through which an individual repeatedly mentally rehearses an action or task without actually physically performing the action or task. The goal of mental practice is to improve performance of those actions or tasks. Mental practice has been proposed as a potential adjunct to physical practice that is commonly performed by survivors of stroke undergoing rehabilitation.
Search date
We searched 10 electronic databases and two clinical trials databases in September 2019.
Study characteristics
We included 25 studies with 676 study participants. Thirty-four per cent of participants were women. In all studies, participants were randomly allocated to groups. The studies, which were reported from nine countries, measured one or more of the following outcomes: arm function for real-life tasks appropriate to the upper limb (e.g. drinking from a cup, manipulating a doorknob), the amount and quality of movement in the arm, and activities of daily living. We sought but did not find evidence related to health-related quality of life, economic costs, and adverse events.
Key results
Our review of the available literature provided moderate-certainty evidence that mental practice, when added to other physical rehabilitation treatment, produced improved outcomes compared to use of the other rehabilitation treatment alone. Evidence to date shows improvements in arm function and arm movement. It is not clear whether (1) mental practice added to physical practice produces improvements in activities of daily living; (2) mental practice alone compared to conventional treatment is beneficial in improving motor control of the arm; (3) how much mental practice could produce the best results; (4) and whether mental practice is best used at a particular time after stroke. No adverse effects or harms were reported in any of the studies.
Certainty of the evidence
For mental practice added to other physical rehabilitation treatment compared to use of the other rehabilitation treatment alone, the certainty of evidence was moderate for arm function and arm movement outcomes based on some challenges in study design. The certainty of evidence was low for the activities of daily living outcome based on study design and the small number of participants included. For the mental practice compared to conventional treatment comparison, the certainty of evidence for the arm movement outcome was determined to be low for the same reasons.

Authors' conclusions: 

Moderate-certainty evidence shows that MP in addition to other treatment versus the other treatment appears to be beneficial in improving upper extremity activity. Moderate-certainty evidence also shows that MP in addition to other treatment versus the other treatment appears to be beneficial in improving upper extremity impairment after stroke. Low-certainty evidence suggests that ADLs may not be improved with MP in addition to other treatment versus the other treatment. Low-certainty evidence also suggests that MP versus conventional treatment may not improve upper extremity impairment. Further study is required to evaluate effects of MP on time post stroke, the volume of MP required to affect outcomes, and whether improvement is maintained over the long term.