Following a stroke, many individuals experience participation limitations secondary to upper extremity hemiparesis (Shenn & Leishear, 2011). Motor imagery, the mental representation of movement without any body movement, is an evidenced-based intervention to optimize upper extremity function for patients following stroke (Dickstein & Deutsch, 2007). Motor imagery is a readily applicable, safe, and cost-effective intervention that can help clients achieve a variety of occupational goals within diverse environments (Guttman, Burstin, Brown, Bril, & Dickstein, 2012). The purpose of this presentation is to present the results of an evidence-based review examining the use of motor imagery to increase functional outcomes for individuals with upper extremity deficits post-stroke. To be included in this review, articles had to meet the following criteria: Levels I-III of evidence, focusing on upper extremity dysfunction post-stroke, with functional outcomes. CINAHL, OVID, Cochrane, and PubMed were searched for peer-reviewed literature published in English between 2005 and 2013. Two authors critiqued each article using the PEDro scale, a reliable assessment tool for randomized controlled trials (Maher, Sherrington, Herbert, Moseley & Elkins, 2003). Findings from 15 articles indicate that motor imagery improves upper extremity function when used in conjunction with standard therapy for patients with chronic and acute stroke. Evidence from this review supports the use of relaxation and graded task performance within a motor imagery protocol. Articles using varied delivery methods and duration, frequency, and intensity of motor imagery revealed statistically significant changes in functional outcomes. Further research is required to determine the most sensitive assessment for detecting these changes and to generalize these results.
These findings suggest that motor imagery is an effective intervention for individuals post-stroke that occupational therapists should consider to improve clients’ participation in activities requiring upper extremity function. Through this presentation, professionals will understand the evidence and clinical implications of motor imagery to improve the quality of care in stroke rehabilitation. Discussion of these concepts will highlight the supports and barriers to implementing this evidence-based intervention in occupational therapy practice.
Dickstein, R., & Deutsch, J. E. (2007). Motor imagery in physical therapy practice. Journal of the American Physical Therapy Association , 87(7), 942-953. doi: 10.2522/ptj.20060331
Guttman, A., Burstin, A., Brown, R., Bril, S., & Dickstein, R. (2012). Motor imagery practice for improving sit to stand and reaching to grasp in individuals with poststroke hemiparesis. Topics in Stroke Rehabilitation, 19(4), 306-319.
Maher, C. G., Sherrington, C., Herbert, R. D., Moseley, A. M., & Elkins, M. (2003). Reliability of the PEDro scale for rating quality of randomized controlled trials. Physical Therapy, 83(8), 713-721.
Shenn, J., & Leishear, K. (2011). Novel techniques for upper extremity training for hemiparesis after stroke. Retrieved from http://pmr.medicine.pitt.edu/content/pdfs/RGR_10.pdf
Recommended CitationNarimanian, Azadeh; Reese, Amanda; Ryabo, Karina; Shepp, Rachel; and Synnestvedt, Annalisa, "Clinical Effectiveness of Motor Imagery Post-Stroke: An Evidence Based Review" (2013). Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day). Paper 10.