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Appears in Collections:Psychology Journal Articles
Peer Review Status: Refereed
Title: Mental practice with motor imagery in stroke recovery: Randomized controlled trial of efficacy
Author(s): Ietswaart, Magdalena
Johnston, Marie
Dijkerman, H Chris
Joice, Sara
Scott, Clare L
MacWalter, Ronald S
Hamilton, Steven J C
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Keywords: motor imagery
motor recovery
therapeutic benefit
Issue Date: May-2011
Date Deposited: 19-May-2014
Citation: Ietswaart M, Johnston M, Dijkerman HC, Joice S, Scott CL, MacWalter RS & Hamilton SJC (2011) Mental practice with motor imagery in stroke recovery: Randomized controlled trial of efficacy. Brain, 134 (5), pp. 1373-1386.
Abstract: This randomized controlled trial evaluated the therapeutic benefit of mental practice with motor imagery in stroke patients with persistent upper limb motor weakness. There is evidence to suggest that mental rehearsal of movement can produce effects normally attributed to practising the actual movements. Imagining hand movements could stimulate restitution and redistribution of brain activity, which accompanies recovery of hand function, thus resulting in a reduced motor deficit. Current efficacy evidence for mental practice with motor imagery in stroke is insufficient due to methodological limitations. This randomized controlled sequential cohort study included 121 stroke patients with a residual upper limb weakness within 6 months following stroke (on average <3 months post-stroke). Randomization was performed using an automated statistical minimizing procedure. The primary outcome measure was a blinded rating on the Action Research Arm test. The study analysed the outcome of 39 patients involved in 4 weeks of mental rehearsal of upper limb movements during 45-min supervised sessions three times a week and structured independent sessions twice a week, compared to 31 patients who performed equally intensive non-motor mental rehearsal, and 32 patients receiving normal care without additional training. No differences between the treatment groups were found at baseline or outcome on the Action Research Arm Test (ANCOVA statistical P = 0.77, and effect size partial η2 = 0.005) or any of the secondary outcome measures. Results suggest that mental practice with motor imagery does not enhance motor recovery in patients early post-stroke. In light of the evidence, it remains to be seen whether mental practice with motor imagery is a valid rehabilitation technique in its own right.
DOI Link: 10.1093/brain/awr077
Rights: The Author(s) 2011. Published by Oxford University Press on behalf of Brain. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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