The Application of a Mental Practice Protocol in the Acute Inpatient Rehabilitation Setting

The Application of a Mental Practice Protocol to Increase the Functional Recovery of the Hemiparetic Upper Extremity in the Acute Inpatient Rehabilitation Setting

The purpose of this randomized controlled trial is to compare the effect of audio-guided mental practice (MP) and video-guided MP on the impairment and functional abilities of upper extremity (UE) hemiparesis following a stroke. Participants are recruited from Adventist Healthcare Rehabilitation Hospital. All participants must be less than one-month post-stroke with moderate UE hemiparesis. Eligible participants are randomly assigned to an experimental group, (MP or repetitive-task practice (RTP)), or the control group.

The MP groups will perform either audio-guided MP or video-guided MP, five days a week, with 20 repetitions of the following tasks: wiping a table, picking up a cup, brushing hair, and turning the pages of a book. The RTP group physically performed the same tasks. The control group received traditional stroke rehabilitation.

The investigators hypothesize that video MP will have greater improvements in UE impairments and functional abilities than audio MP, RTP, and/or traditional therapy.

Inclusion Criteria:

• Primary diagnosis of stroke
• Less than one-month post-stroke
• Hemiparesis of one upper extremity
• Moderate upper extremity impairment

Exclusion Criteria:

• History of prior stroke
• Comorbidities (severe neurological, orthopedic, rheumatoid, or cardiac impairments)
• Severe spasticity
• Severe cognitive impairments
• Inability to perform mental imagery
• Severe aphasia based on speech therapist evaluation
• Low English proficiency
• Severe pain