Examining the delivery mode of mental practice in reducing hemiparesis: A randomized controlled trial

Background: Mental Practice (MP) is an effective intervention to address upper extremity (UE) hemiparesis post-stroke. However, parameters for the delivery mode of MP have not been defined. Therefore, this study's purpose was to define delivery mode parameters by comparing the effectiveness of audio-guided and video-guided MP.

Method: Eighteen participants, < 1-month post-stroke, with UE hemiparesis were randomized to a MP, repetitive task practice (RTP) or control group. The MP groups performed audio-guided or video-guided MP, 5x/week. The RTP group physically performed the functional tasks. The control group received traditional stroke rehabilitation. The Fugl-Meyer Assessment (FMA-UE) and Wolf Motor Function Test (WMFT) were used to assess change in UE hemiparesis.

Results: Wilcoxon signed-rank test demonstrated audio MP increased FMA-UE scores from pretest (Mdn = 34.0, Mean = 34.0, SD =9.56) to posttest (Mdn = 49.0, Mean = 49.6, SD =7.5), p = .042, r = .64. Similar improvement in FMA-UE scores was found with traditional therapy. Audio MP decreased WMFT time, pretest (Mdn = 10.5, Mean = 49.9, SD = 59.1) to posttest (Mdn = 4.1, Mean = 3.5, SD = 1.4), p =.043, r =.63.

Conclusion: Audio MP and traditional therapy appear to decrease impairment and increase the functional abilities of the UE following stroke. Video MP and RTP does not have this effect.