Centre of Expertise in Life Sciences, Research Centre Autonomy and Participation, School of Professional Education, Zuyd University, Heerlen, The Netherlands.
J Am Med Dir Assoc. 2012 Jan;13(1):85.e1-7. doi: 10.1016/j.jamda.2010.07.009. Epub 2010 Oct 25.
Systematic reviews suggest that mental practice as an additional therapy for people with stroke might be effective and suggest that more trials with better defined interventions are needed. This study investigated whether imagining the skilled movement systematically can contribute to a quicker and/or better recovery of stroke patients in long term care.
A multicenter randomized controlled trial.
Dutch nursing homes.
Stroke patients in the subacute phase of recovery.
Study participants were randomly assigned to the control or experimental group. Over a 6-week intervention period, both groups received multi professional therapy as usual. Additionally, patients in the experimental group had instruction on mental practice with a 4-step framework embedded in regular therapy time.
Outcomes were assessed at 6 weeks and 6 months with the patient-perceived effect on performance of daily activities (10-point Numeric Rating Scale). Six secondary outcomes on impairment and activity level were also assessed. Primary analyses were performed according to the intention-to-treat principle. Generalized estimating equations (GEE) were used to analyze effects.
Thirty-six adult stroke patients (average age 77.8, ± 7.2 years) participated in the trial. No effect in favor of the mental practice intervention on any outcome measure could be detected at either measuring points.
This study could not show differences between embedded mental practice and current standard of care. However, stroke pathways in Dutch nursing homes select specific and frail patients, which might have reduced the effects of training.
系统评价表明，心理练习作为一种对中风患者的附加治疗方法可能是有效的，并表明需要更多具有更好定义干预措施的试验。本研究旨在探讨系统地想象熟练运动是否有助于长期护理中中风患者更快和/或更好地康复。
多中心随机对照试验。
荷兰养老院。
处于恢复期亚急性期的中风患者。
研究参与者被随机分配到对照组或实验组。在 6 周的干预期间，两组均接受多专业常规治疗。此外，实验组患者在常规治疗时间内接受了包含 4 个步骤框架的心理练习指导。
在 6 周和 6 个月时，通过患者对日常活动表现的感知效果（10 分数字评定量表）进行评估。还评估了 6 项二级损伤和活动水平指标。主要分析按照意向治疗原则进行。使用广义估计方程（GEE）分析效果。
36 名成年中风患者（平均年龄 77.8 ± 7.2 岁）参加了试验。在任何测量点都没有发现心理练习干预对任何结果测量指标有有利影响。
本研究未能显示嵌入式心理练习与当前标准护理之间的差异。然而，荷兰养老院的中风途径选择了特定的体弱患者，这可能降低了训练的效果。
