Effects of mental practice embedded in daily therapy compared to therapy as usual in adult stroke patients in Dutch nursing homes: design of a randomised controlled trial

In the 16 years since has your stroke hospital applied the learnings from this? NO? THEN WHY HAVEN'T YOU FIRED THE BOARD OF DIRECTORS?

Effects of mental practice embedded in daily therapy compared to therapy as usual in adult stroke patients in Dutch nursing homes: design of a randomised controlled trial

 Published: 15 October 2007
BMC Neurology
 2007,
7
:34doi:10.1186/1471-2377-7-34
 
BioMed
 
Central
Page 1 of 13
(page number not for citation purposes)
BMC Neurology
Open Access
Study protocol
Effects of mental practice embedded in daily therapy compared to therapy as usual in adult stroke patients in Dutch nursing homes: design of a randomised controlled trial
SusyMBraun*
1,2,3,4
, AnnaJBeurskens 2,3, 

SusanneMvan Kroonenburgh 5, 

JeroenDemarteau 6, 

JosMSchols 5,7,8
 and DerickTWade 9,10
 Address:
1  The centre of expertise in life sciences, Zuyd University, Heerlen, The Netherlands,
2  The department of health and technique, Zuyd University, Heerlen, The Netherlands,
3  The research centre autonomy and participation, Zuyd University, Heerlen, The Netherlands,
4  The care & public health institute, Maastricht University, Maastricht, The Netherlands,
5 Klevarie nursing home, Vivre foundation, Maastricht, The Netherlands,
6 Nursing home St. Camillus, Land van Gelre en Gulick, Roermond, The Netherlands,
7 Department of general practice, Maastricht University, The Netherlands,
8 Department Tranzo, Tilburg University, Tilburg, The Netherlands,
9 Department of rehabilitation, Maastricht University, Maastricht, The Netherlands and
10 Oxford centre for enablement, Oxford, UK Email: SusyMBraun*-s.braun@hszuyd.nl; AnnaJBeurskens-s.beurskens@hszuyd.nl; SusanneMvan Kroonenburgh-svankroonenburgh@vivre.nl; JeroenDemarteau-jeroendemarteau@home.nl; JosMSchols-jos.schols@HAG.unimaas.nl; DerickTWade-derick.wade@noc.anglox.nhs.uk * Corresponding author

Abstract

Background:
 

Mental practice as an additional cognitive therapy is getting increased attention instroke rehabilitation. A systematic review shows some evidence that several techniques in whichmovements are rehearsed mentally might be effective but not enough to be certain. This trialinvestigates whether mental practice can contribute to a quicker and/or better recovery of strokein two Dutch nursing homes. The objective is to investigate the therapeutic potential of mentalpractice embedded in daily therapy to improve individually chosen daily activities of adult strokepatients compared to therapy as usual. In addition, we will investigate prognostic variables andfeasibility (process evaluation).
 

Methods:
 

A randomised, controlled, observer masked prospective trial will be conducted with adult stroke patients in the (sub)acute phase of stroke recovery. Over a six weeks intervention period the control group will receive multi professional therapy as usual. Patients in the experimental group will be instructed how to perform mental practice, and will receive care as usual in which mental practice is embedded in physical, occupation and speech therapy sessions.Outcome will be assessed at six weeks and six months. The primary outcome measure is the patient perceived effect on performance of daily activities as assessed by an 11-point Likert Scale.Secondary outcomes are: Motricity Index, Nine Hole Peg Test, Barthel Index, Timed up and Go,10 metres walking test, Rivermead Mobility Index. A sample size of the patients group and all therapists will be interviewed on their opinion of the experimental program to assess feasibility. All patients are asked to keep a log to determine unguided training intensity.
Discussion:
Advantages and disadvantages of several aspects of the chosen design are discussed.
Trial registration:
ISRCTN27582267