Effect of imagery perspective on occupational performance after stroke: a randomized controlled trial.

OBJECTIVE This preliminary study sought to determine whether the imagery perspective used during mental practice (MP) differentially influenced performance outcomes after stroke. METHOD Nineteen participants with unilateral subacute stroke (9 men and 10 women, ages 28-77) were randomly allocated to one of three groups. All groups received 30-min occupational therapy sessions 2×/wk for 6 wk. Experimental groups received MP training in functional tasks using either an internal or an external perspective; the control group received relaxation imagery training. Participants were pre- and posttested using the Fugl-Meyer Motor Assessment (FMA), the Jebsen-Taylor Test of Hand Function (JTTHF), and the Canadian Occupational Performance Measure (COPM). RESULTS At posttest, the internal and external experimental groups showed statistically similar improvements on the FMA and JTTHF (p < .05). All groups improved on the COPM (p < .05). CONCLUSION MP combined with occupational therapy improves upper-extremity recovery after stroke. MP does not appear to enhance self-perception of performance. This preliminary study suggests that imagery perspective may not be an important variable in MP interventions.