Transcript of Mental-practice-in-OT-Stroke-LLL event-London region. freeman.pp.ppt
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- The Use of Mental Practice in Occupational Therapy for Stroke
Patients
Mental Practice
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- Definition of mental practice
- The effectiveness of mental practice
- The use of mental practice in stroke rehabilitation and in
occupational therapy
- Areas for further research
Objectives
- What is mental practice?
- the symbolic rehearsal of a physical activity in the absence of
any gross muscular movements (Richardson, 1967)
- Mental practice is achieved through the use of mental
imagery
- The effects of mental and physical practice are functionally
similar
- Types of mental imagery
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- eg Imagining the movement of a visual form
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- eg imagining your own hand moving
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- eg imagining the feeling of your hand moving
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- Internal Imagery- an internal recreation of the task:
- Effective for planning a task
- External Imagery- an outside perspective of performance:
- More effective for learning & subsequent retention
Types of mental imagery
- The effectiveness of mental practice
- Combined with physical practice,
- improves performance to the same, or a higher extent than
physical practice alone
- increases the rate of skill acquisition
- may facilitate greater performance than that of a control
condition of no input
- Stroke rehabilitation approaches
- All approaches involve the process of re-learning
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- Neurodevelopmental treatment (Bobath)
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- Motor re-learning (Carr & Shepherd)
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- Task- oriented approaches
- Mental practice theories
- It is debated whether mental practice relies on motor,
cognitive or motivational processes
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- Mental practice is more effective when learning simple
tasks
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- Imagery abilities may vary
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- Tasks learned must be meaningful & prior experience of the
activity is necessary
- How mental imagery can promote functional independence through
relearning
- Mental practice used in occupational therapy
- Page, Levine & Leonard (2005)
- Investigated the efficacy of mental practice in increasing the
function & use of the affected upper limb of 11 stroke
patients.
- Randomized, controlled pre-post case series study
- Tasks were reaching & grasping a cup, turning pages &
using a pen.
- Mental practice used in occupational therapy
- Page, Levine & Leonard (2005)
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- Increased affected limb use and function
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- Skills had been generalized to other ADLs after
intervention
- Mental practice used in occupational therapy
- Studied the effectiveness of visuomotor imagery practice in
rehabilitation of unilateral neglect
- Before / after trial on 2 participants
- Mental imagery included imagining patients at home,
geographical areas, reverse spelling & mental
representation.
- Mental practice used in occupational therapy
- Outcomes assessed using functional tests &
neuropsychological tests
- Visuomotor imagery training found to improve performance
deficits related to neglect
- Mental practice used in occupational therapy
- Studied the efficacy of mental imagery at promoting relearning
for people after a stroke
- Prospective, randomized controlled trial, of 46 stroke
inpatients aged over 60 years.
- MP Protocol used picture cards, visualizing performance and
watching videotaped performance
- Mental practice used in occupational therapy
- Outcome measures used were the performance of 15 trained and 5
untrained daily living tasks
- Patients who engaged in mental practice improved their
attention & sequencing ability
- Increased their relearning of familiar and new tasks
- Benefits of using mental practice
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- Increases affected limb use and function
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- Can improve cognitive skills (eg attention, sequencing)
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- Creates opportunities for clients to problem-solve
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- Uses a client-centred approach
- Areas for further research
- Establishing guidelines and protocols
- Motivational aspects of relearning through mental practice
- Long-term occupational benefits
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Mental Practice
- References
- Bell, A. & Murray, B (2004) Improvement in Upper Limb Motor
Performance following Stroke: the Use of Mental Practice. British
Journal of Occupational Therapy 67 (11): 501-507.
- Kosslyn,S.M. (1994) Image and brain : the resolution of the
imagery debate. Cambridge, Mass. ; London : MIT Press
- Liu, K. P., Chan, C. C., Lee, T., Hui-Chan, C. W. (2004) Mental
Imagery for Promoting Relearning for People After Stroke: A
Randomized Controlled Trial. Archives of Physical Medical
Rehabilitation 85:1403-8.
- Page, S. Levine, P. Leonard, A. (2005) Effects of Mental
Practice on Affected Limb Use and Function in Chronic Stroke.
Archives of Physical & Medical Rehabilitation 86 399-402.
- Richardson, A (1967) Mental Practice: a review and discussion
(part 1). Research Quarterly (38): 95-107
- Smania, N., Bazoli, .F, Piva, D., Guidetti, G. (1997)
Visuomotor imagery and rehabilitation of neglect. Archives of
Physical & Medical Rehabilitation, 78:430-6.
- Van Leeuwen, R., Inglis, J.T. (1998) Mental practice and
imagery: a potential in stroke rehabilitation. Physical Therapy
Reviews 3 :47-52.