Mental imagery for promoting relearning for people after stroke: a randomized controlled trial.

OBJECTIVE

To study the efficacy of mental imagery at promoting relearning for people after a stroke.

DESIGN

Prospective, randomized controlled trial.

SETTING

An inpatient rehabilitation stroke unit in Hong Kong.

PARTICIPANTS

Forty-six inpatients, 60 years of age or older, after a cerebral infarction.

INTERVENTIONS

Patients were randomized to receive 15 sessions (1 h/d for 3 wk) of either the mental imagery program or the conventional functional training intervention on the relearning of daily living tasks.

MAIN OUTCOME MEASURES

Performance of 15 trained and 5 untrained tasks, including household, cooking, and shopping tasks; and the Fugl-Meyer Assessment and Color Trails Test (CTT).

RESULTS

Patients engaged in mental imagery-based intervention showed better relearning of both trained and untrained tasks compared with the control group (trained tasks: P<.005; untrained tasks: P<.001). They also demonstrated a greater ability to retain the trained tasks after 1 month and transfer the skills relearned to other untrained tasks (P<.001). However, among the various ability measures, the mental imagery group showed a significant increase in the CTT scores only after the intervention (P<.005).

CONCLUSIONS

Mental imagery can be used as a training strategy to promote the relearning of daily tasks for people after an acute stroke. The imagery process is likely to improve the planning and execution of both the trained and the untrained (novel) tasks. The effect of its relearning appears to help patients to retain and generalize the skills and tasks learned in the rehabilitation program.