Using Motor Imagery in the Rehabilitation of Hemiparesis

Two survivors of embolic middle cerebral artery stroke that resulted in chronic hemiparesis received training consisting of 12 one-hour sessions, 3 times a week, for 4 consecutive weeks, of imagining wrist movements (extension, pronation-supination) and mental simulations of reaching and object manipulation, making use of a mirror box apparatus.

Two clinical assessments, grip strength, 4 wrist functionality measurements, and 3 timed performance tests were used as outcome measures, taken before training began, at 3 times during the intervention month, and twice for additional long-term measurements.

Performance of the paretic limb improved after the imagery intervention, as indicated by increases in assessment scores and functionality and decreases in movement times. The improvements over baseline performance remained stable over a 3-month period.

The study suggests that these results demonstrate the potential for using motor imagery as a cognitive strategy for functional recovery from hemiparesis. The researchers felt that the intervention targeted the cognitive level of action processing, while its effects may be realized in overt behavioral performance.

Citation: Stevens JA, Stoykov ME. Using motor imagery in the rehabilitation of hemiparesis. Archives of Physical Medicine and Rehabilitation. 2003 July; 84 (7): pp. 1090-2. j-stevens3@northwestern.edu