Monday, October 11, 2021

Audio-Guided Versus Video-Guided Mental Practice in Reducing Upper Extremity Hemiparesis

Have your doctor get the audio for the mental practice.

Audio-Guided Versus Video-Guided Mental Practice in Reducing Upper Extremity Hemiparesis

https://doi.org/10.1016/j.apmr.2021.07.600Get rights and content

Research Objectives

To compare the effect of audio-guided mental practice (MP) and video-guided MP on impairment and functional abilities of upper extremity (UE) hemiparesis following stroke.

Design

Randomized controlled trial. Participants were randomly assigned: audio-guided MP, video-guided MP, repetitive task practice (RTP), or traditional therapy (control) groups. Baseline and post-intervention scores from outcome measures were compared.

Setting

Inpatient Rehabilitation Hospital.

Participants

Inclusion Criteria: ages 18-80, less than one month post stroke, moderate UE hemiparesis. Exclusion: history of prior stroke, severe pain, comorbidities, spasticity, aphasia or cognitive impairments, inability to perform MP, non-english speaking.18 participants completed the study, two participants were eligible and refused.

Interventions

MP groups performed MP five days a week (via video or audio guidance), of the following tasks: wiping a table, picking up a cup, brushing hair, and turning the pages of a book. The RTP group physically performed the same tasks. The control group received traditional stroke rehabilitation.

Main Outcome Measures

Wolf Motor Function Test (WMFT) and Fugl Meyer Assessment- Upper Extremity (FM).

Results

Wilcoxon signed-rank test demonstrated that audio MP increased FM scores from pre-test (Mdn = 34.0, Mean = 34.0, SD =9.56) to post-test (Mdn = 49.0, Mean = 49.6, SD =7.5), n= 5, Z= 2.03, p= .042, r= .91). Similar improvement in FM scores was found with traditional therapy. Audio MP also decreased WMFT time, pre-test (Mdn = 10.5, Mean = 49.9, SD= 59.1) to post-test (Mdn = 4.1, Mean 3.5, SD = 1.4), Z=2.02, p=.043, r=.90.

Conclusions

Audio MP and traditional therapy appear to decrease impairment and increase the functional abilities of the UE following stroke. Video MP and RTP did not have this effect. These preliminary findings expand therapeutic options to existing occupational therapy practice in stroke rehabilitation.

 

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