Article

OBJECTIVE: To evaluate and compare efficacy of 20-, 40-, and 60-minute mental
practice sessions on affected upper extremity impairment and functional
limitation. DESIGN: Randomized controlled study with multiple baseline design.
SUBJECTS: Twenty-nine subjects with chronic stroke and exhibiting stable, mild
hemiparesis. INTERVENTIONS: Subjects were given 30-minute rehabilitative sessions
3 days/week for 10 weeks, emphasizing affected upper extremity use during valued
activities. Directly after these sessions, randomly selected subjects were given
audiotaped mental practice for 20, 40, or 60 minutes. Subjects assigned to a
control group received the same therapy as the mental practice groups, and an
audiotaped sham intervention directly after therapy sessions. MAIN OUTCOME
MEASURES: Fugl-Meyer (FM) motor assessment and Action Research Arm Test (ARAT).
RESULTS: No pre-existing differences were found between groups on any demographic
variable or movement scale. On the FM, mental practice duration significantly
predicted pretesting to post change (P = 0.05), with increasing duration related
to larger FM score increases (5.4 point score increase for the 60-minute duration
group). On the ARAT, a non-significant trend was seen (P = 0.78), favoring the
20-minute dosing condition (4.5 point increase). Importantly, regardless of
dosing condition, subjects administered mental practice exhibited markedly larger
score changes on both the FM and ARAT than subjects not receiving mental
practice. CONCLUSIONS: Sixty minutes of mental practice appears to most
significantly reduce affected arm impairment. However, no clear change pattern
was seen in affected arm functional limitation according to mental practice
duration. Results suggest that a stroke rehabilitative regimen augmented by
mental practice renders a greater functional impact than therapy only.

Langue : ANGLAIS