Interested in building upon recent studies showing that imagery helps post-stroke patients relearn daily tasks, researchers from the Hong Kong Polytechnic University in Kowloon, Hong Kong, China investigated whether imagery could also help with generalizing skills on trained and untrained tasks in new environments in a small, randomized, controlled clinical trial. 

Thirty-five acute post-stroke patients were randomly assigned to an imagery training group (n=18) or conventional functional rehabilitation (n=17) group. The imagery intervention was 3-weeks of standardized practices and daily tasks using chunking-regulation-rehearsal strategies.

Outcome measurements were the performances on trained and untrained tasks in the training and novel environments.

Researchers from the All India Institute of Medical Sciences in New Delhi examined the short-term impact of a brief yoga intervention on some of the biochemical risk indicators for cardiovascular disease and diabetes mellitus.

Ninety-eight subjects (67 male, 31 female), ages 20-74, with hypertension, coronary artery disease, diabetes mellitus, and a variety of other illnesses, participated in a lifestyle training program that consisted of yoga asanas (postures), pranayama (breathing exercises), relaxation techniques, group support, individualized advice, lectures and films on the philosophy of yoga and the place of yoga in daily life, meditation, stress management, nutrition, and knowledge about their disease.

Imagery Rehearsal Found Critical in Motor Rehab for Stroke, Better than Physical Practice Alone

Researchers from the University of Lyon in Bron Cedex, France tested whether "mental rehearsal" (motor imagery) is equivalent to physical learning in restoring motor function in hemiplegic patients (paralyzed on one side), and examined what would be optimal proportions of real execution vs. rehearsal.

Subjects were asked to grasp an object and insert it into an adapted slot. One group (G0) practiced the task only by physical execution (240 trials); three groups imagined performing the task in different rates of trials (25%, G25; 50%, G50; 75%, G75), and physically executed movements for the remaining trials; a fourth, control group imagined a visual rotation task in 75% of the trials and then performed the same motor task as the other groups.

In Neurological Rehab, Imagining Movement Delivers the Goods

A Dutch literature review concludes that imagining movement creates the same flow of sensory information that leads to the reacquisition of motor skills.

In rehab, active exercising creates the flow of sensory information responsible for the learning or relearning of lost (or newly needed) motor skills. This review article addresses whether active physical exercise is always necessary for creating this sensory flow.

It points to numerous studies indicating that motor imagery can result in the same plastic changes in the motor system that actual physical practice provides. Motor imagery is the mental execution of a movement without any overt, corresponding movement or without any peripheral (muscle) activation.

 

Guided Motor Imagery Helps with Athletic Performance, Neurological Conditions

Investigators at the University of Haifa in Israel reviewed the literature to determine the positive effects of guided motor imagery practice on motor performance. There is abundant evidence that motor performance is improved in athletes, people who are healthy, and people with neurological conditions, such as stroke, spinal cord injury and Parkinson’s disease. This article discusses how to integrate motor imagery into a physical therapy practice and goes into particulars of visual and kinesthetic motor imagery, factors that modify motor imagery practice, the design of motor imagery protocols, and potential applications of motor imagery.

Citation: Dickstein R, Deutsch JE. Motor imagery in physical therapist practice. Physical Therapy. 2007 Jul; 87 (7): pages 942-53. Epub 2007 May 1 This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

Phase II research from Page and Levine at the University of Cincinnati shows further evidence of the efficacy of "mental practice" (kinesthetic or body-based guided imagery) for rehabilitation of arm movements after a stroke.

A research team from the Department of Physical Medicine and Rehabilitation at the University of Cincinnati College of Medicine completed a randomized, controlled study that compared the efficacy of a stroke rehabilitation program that incorporated "mental practice" (MP) or guided imagery of certain arm movements to a placebo condition.

Researchers at the Department of Rehabilitation Sciences at Hong Kong Polytechnic University studied the efficacy of mental imagery at promoting relearning for people after a stroke.

This randomized, controlled trial in an inpatient rehabilitation stroke unit tested 46 inpatients, 60 years of age or older, who had suffered a cerebral infarction (stroke). Subjects were randomized to receive 15 sessions, one hour per day for 3 weeks, of either the mental imagery program or conventional training for relearning daily living tasks. Testing was then done on performance of 15 trained and 5 untrained tasks, including household, cooking, and shopping tasks; and the Fugl-Meyer Assessment and Color Trails Test (CTT).

Two reviews of the literature, one from Cambridge in England and one from Zuyd University in The Netherlands, suggest that guided imagery holds promise as a rehabilitation strategy for regaining motor control after a stroke.

Investigators from the Department of Clinical Neurosciences at The University of Cambridge, England, reviewed the literature on the efficacy of guided imagery as a rehabilitation strategy after a stroke. In spite of study inconsistencies and methodological roadblocks, the literature suggests that motor imagery has an encouraging effect on motor recovery after stroke.