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 (1h/d for 3wk) 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. Copyright © 2004 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.