Document Type

Critically Appraised Topic

Publication Date

2011

Clinical Scenario

Roughly 795,000 Americans experience a new or recurrent stroke each year (American Heart Association, 2011). Individuals who withstand a stroke often encounter motor impairments that may impact their ability to perform various significant and purposeful activities on a daily basis. Hemiparesis is a typical neurological impairment that is displayed after a stroke and can range from weakness to complete paralysis of the affected side (Woodson, 2008). A number of interventions have been explored in the rehabilitation setting to remediate and restore functional performance in the affected limb in stroke recovery. For instance, mirror therapy in addition to a standard rehabilitation program (Yavuzer et al. 2008) and constrained-induced movement therapy (Taub, Crago, & Uswatte,1998) have been utilized, demonstrating improvements in hand and arm function for clients with subacute and chronic stroke. Mental practice has also been a therapy explored in recent studies, finding similar effects (Page, 2000; Muller, Butefisch, Rudiger, & Homberg, 2007).

Mental practice is a training method that uses a number of cognitive processes, including motor imagery, that consists of repeating imagined motor acts several times to improve performance. This may be used to learn a new skill or ability or perfect one that is familiar (Jackson, Lafleur, Malouin, Richards, & Doyon, 2001). With this in mind, this CAT has been conducted to investigate the impact that mental practice training has on performance of daily tasks in clients post-stroke, rather than focusing solely on improvements of residual impairments.

Clinical Question

What impact does mental practice training have on performance of daily tasks in clients post stroke?

Clinical Bottom Line

Mental practice (MP) appears to provide positive effects in functional recovery for clients post-stroke with hemiparesis when used along with physical practice in rehabilitation. A specific intervention protocol cannot be justified as more effective than others due to the inconsistent MP strategies used among the studies found. Future research is needed to identify if improvements in affected limb functioning on performance of tasks can be retained and implemented in occupations of daily living.

Share

COinS