Mental Practice in Stroke Rehabilitation

We've known about the benefits of this for years. Why the fuck didn't you create EXACT PROTOCOLS on this? Your mentors and senior researchers incompetently didn't let you know of all the previous research and didn't consider the next step was to create protocols?  

• mental practice (12 posts to July 2015)

• Lucid dreaming.motor imagery (1 post to February 2021)

• Motor imagery (66 posts to January 2013) 

• Mental imagery (29 posts to October 2010) 

• Guided Motor Imagery (1 post to September 2021) 

• Graded Motor Imagery (1 post to January 2016) 

• Mental Practice in Stroke Rehabilitation

Task-related mindfulness practices (MP) are a relatively new(Not new at all) treatment receiving increasing attention in rehabilitation research. Mental practice, often referred to as Motor Imagery or Mental Imagery, requires an individual to imagine performing a task or any physical movement without having to physically perform it do it and thus stimulate the nervous system.

Richardson defines MP as “the symptomatic process of exercise in the absence of noxious tissue”[1].

While athletes and musicians are aware of the benefits of mindfulness practice which has been proven and well documented to be beneficial in improving their performance and thereby enhancing their athletic training and other skills. [3] [4][5] [6] [7] There have been many studies on Stroke patients to determine the efficacy of MP to improve functional independence and daily functional activities[8][9][10] and to increase gait speed[11] and improve balance[12].

 

What is Mental Practice?

The main theoretical interest of MP is when we are cognitively practicing an activity and that the same neurons are activated as if we were performing the activity [1] So over time, mentally practicing activity of such varieties will give us a degree of study of the body as we find it during the physical study of work. Motor operation imaging can be initiated in the acute phase subacute phase or chronic phase of rehabilitation. It has been suggested that although body painting itself is helpful [13] it is better when used as an adjunct to physical therapy.[14] [15]Several primary studies on motor imagery were designed to analyze it whether body images improved athletes’ physical abilities.

Types of Mental Practice

• Kinaesthetic motor imagery(KMI)– KMI is described as the ability to visualize the sensations associated with the movement.[16]
• Visual motor imagery(VMI) –VMI is defined as the ability to visualize movement.[16]

Evidence for the Use of Mindfulness in Stroke Rehabilitation

Several studies have been conducted to examine the effectiveness of psychological practices in stroke rehabilitation:

Upper Limb Rehabilitation after Stroke

1. Park et al. [14] performed a systematic review and meta-analysis showing that MP is an effective safety resource and may be a viable adjunct rather than a direct replacement for traditional rehabilitation, depending on the therapist and patient request plan. Is there neurofeedback. Results vary depending on the therapy given. Considering the potential advantages of brain-computer interface (BCI) in the clinical application of MP, further development of MP is needed.
2. Braun et al. [17] conducted a systematic review to determine the effectiveness of mental exercises as an add-on therapy for arm function recovery after stroke. Although a single case study shows that mental exercises hold promise for improving leg function. they concluded Further research using clear definitions of psychological practice content and standardized measures of outcomes is needed to establish MP as an effective treatment.
3. Barclay-Goddard et al. [15] conducted a systematic review to investigate the effectiveness of mental exercises for treating upper extremity dysfunction in post-stroke hemiplegic patients. Results show that mental exercises are more effective as an adjunct to other treatments Superior to MP alone in improving upper extremity function.
4. Park et al. [13] assessed the effects of mental exercises on upper extremity function and activities of daily living (ADL) in stroke patients. Their results showed significant improvements in Action Research Arm Test (ARAT), Fugl-Meyer Assessment (FMA) and Modified Barthel Index (MBI) score concluded that mental exercises are effective in improving upper extremity function and performance of daily activities in stroke patients.

Functional recovery and performance in activities of daily living

1. et al. [10] conducted a systematic review to investigate the effectiveness of mental exercises for the treatment of upper extremity dysfunction in hemiplegic patients after stroke. The results suggest that mental exercises are more effective when used as an adjunct to other treatments to improve Upper extremity function was superior to MP alone.
2. Cha et al. [9] conducted a meta-analysis to evaluate the efficiency of functional task training and mental exercises in stroke patients. Findings suggest that functional task training and mental exercises delivered by occupational and physical therapists in stroke rehabilitation are functionally effective.
3. Braun et al. [8] further conducted the meta-analysis and concluded that mental exercises may have a positive effect on the performance of activities in patients with neurological disorders due to their good imagery compliance and adherence to the intervention.
4. D Gracia [18] conducted a systematic review to examine the potential utility and clinical effectiveness of MP in rehabilitation and functional recovery. They found that MP was effective and safe for upper extremity and upper extremity functional rehabilitation when used in conjunction with conventional physical therapy Restoration of lower limbs and activities of daily living and skills. However, they concluded that further research is needed to determine the best treatment options.

Lower Limb Rehabilitation after Stroke

1. Oostra et al. [11] conducted a randomized controlled trial to evaluate the effect of motor imagery on gait rehabilitation and to study the effect of mental exercises on motor imagery in patients with subacute stroke. The trial randomly assigned patients to receive muscle relaxation or less Physical mental imagery exercises. The outcome used to measure gait speed was the 10-meter walk test after treatment (6 weeks). Significant differences were found between the two groups following treatment that supported lower extremity mental imagery exercises and muscle relaxation.
2. To determine whether motor imagery training resulted in clinical improvement in gait after stroke, Cho et al. [12] conducted a randomized controlled trial. The trial randomized patients to receive either gait training or mental imagery and gait. The result for measuring gait speed is 10 meters Post-treatment walk test (4 weeks). Significant differences were found between the two groups when supporting mental imagery and gait training after treatment versus gait training alone.

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