Efficacy of Mental Practice on Rehabilitation of Hand Function in Patients with Post-stroke: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

WANG Pu ¹ ,  GOU Yi ^2,3 , ZHANG Junmei ^4,5 , ZHAO Lei ² , CUI Xiaochen ² , LIAO Weijing ¹ , YUE Guanghui ⁵

1. Department of Rehabilitation Medicine, Zhongnan Hospital, Wuhan University, Wuhan 430071, China;2. Department of Epidemiology, College of Public Health, Wuhan University, Wuhan 430071, China; 3. State Key Lab of Virology, Wuhan University, Wuhan 430071, China;;

Corresponding author：

GOU Yi, Email: guoyi@whu.edu.cn

Keywords：

Post stroke; Mental Practice; Rehabilitation; Randomized controlled trial; Systematic review; Meta-analysis

DOI：

10.7507/1672-2531.20110095

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Objective?To evaluate Mental Imagery on rehabilitation of functions in patients with stroke. Methods?Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMbase, PEDro (www.pedro.org.au), OpenSIGLE, National Technical Information Service (NTIS), CNKI, VIP, Wanfang Data, and CBM were searched for the Randomized controlled trials (RCTs) of Mental Imagery on rehabilitation of functions in patients with stroke from the date of establishment of the databases to October 2010. The bibliographies of the included studies were searched, too. Three independent researchers evaluated the included studies using GRADE. The extracted data were analyzed by RevMan 5.0.25 and GRAEDprofiler 3.2.2. Results?A total 16 trials were discovered. Meta-analyses showed that at the end of 4th, 6th, and 8th, compared with conventional rehabilitation, the mental practice increased the score measured by FMA (WMD=7.81, 95%CI 1.96 to 13.65; WMD=13.89, 95%CI 4.53 to 23.25; and WMD=9.45, 95%CI 3.67 to 15.23, respectively) and ARAT (WMD=5.70, 95%CI 3.17 to 8.22, P=0.30). The 4 outcomes were all of low quality in the GRADE system. Conclusion?The current evidence shows mental practice could improve the upper limb function in patients after stroke, and the side effects of mental practice are not found in meta-analyses. Compared with other rehabilitative therapies, it is simper, of lower input costs, and of low operating costs. The clinicians should recommend it. Due to the limitations of the included studies, more large-sample, high-quality RCTs are required.

Citation： WANG Pu,GOU Yi,ZHANG Junmei,ZHAO Lei,CUI Xiaochen,LIAO Weijing,YUE Guanghui. Efficacy of Mental Practice on Rehabilitation of Hand Function in Patients with Post-stroke: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2011, 11(5): 529-539. doi: 10.7507/1672-2531.20110095 Copy

1.	7 Duncan PW, Zorowitz R, Bates B, et al . Management of Adult Stroke Rehabilitation Care: a clinical practice guideline. Stroke , 2005, 36(9): e100-e143.
2.	8 Page SJ, Levine P, Leonard AC. Effects of mental practice on affected limb use and function in chronic stroke. Arch Phys Med Rehab , 2005, 86(3): 399-402.
3.	9 Callow N, Hardy L. Types of imagery associated with sport confidence in netball players of varying skill levels. J Appl Sport Psychol , 2001, 13(1): 1-17.
4.	10 Ryan ED, Simons J. Cognitive demand, imagery, and frequency of mental rehearsal as factors influencing acquisition of motor skills. Journal of Sport Psychology , 1981, 3(1): 35-45.
5.	11 Decety J, Jeannerod M, Prablanc C. The timing of mentally represented actions. Behav Brain Res , 1989, 34(1-2): 35-42.
6.	12 Sharma N, Pomeroy VM, Baron JC. Motor imagery: a backdoor to the motor system after stroke? Stroke , 2006, 37(7): 1941-1952.
7.	13 Jackson PL, Lafleur MF, Malouin F, et al . Potential role of mental practice using motor imagery in neurologic rehabilitation. Arch Phys Med Rehab , 2001, 82(8): 1133.
8.	16 Atkins D, Best D, Briss PA, et al . Grading quality of evidence and strength of recommendations. BMJ (Clinical research ed.) , 2004, 328(7454): 1490.
9.	21 Riccio I, Iolascon G, Barillari MR, et al . Mental practice is effective in upper limb recovery after stroke: a randomized single-blind cross-over study. Eur J Phys Rehabil Med , 2010, 46(1): 19-25.
10.	26 Müller K, Butefisch CM, Seitz RJ, et al . Mental practice improves hand function after hemiparetic stroke. Restor Neurol Neurosci , 2007, 25(5-6): 501-511.
11.	27 Page SJ, Levine P, Leonard A. Mental practice in chronic stroke: results of a randomized, placebo-controlled trial. Stroke , 2007, 38(4): 1293-1297.
12.	28 Page SJ, Levine P, Leonard AC. Effects of mental practice on affected limb use and function in chronic stroke. Arch Phys Med Rehab , 2005, 86(3): 399-402.
13.	29 Dijkerman HC, Ietswaart M, Johnston M, et al. Does motor imagery training improve hand function in chronic stroke patients? A pilot study. Clin Rehabil , 2004, 18(5): 538-549.
14.	30 Liu KP, Chan CC, Lee TM, et al . Mental imagery for promoting relearning for people after stroke: a randomized controlled trial. Arch Phys Med Rehabil , 2004, 85(9): 1403-1408.
15.	31 Page SJ, Levine P, Sisto S, et al . A randomized efficacy and feasibility study of imagery in acute stroke. Clin Rehabil , 2001, 15(3): 233-240.
16.	33 Fugl-Meyer AR, Jaasko L, Leyman I, et al . The post-stroke hemiplegic patient. 1. A method for evaluation of physical performance. Scand J Rehabil Med , 1975, 7(1): 13-31.
17.	34 Lyle RC. A performance test for assessment of upper limb function in physical rehabilitation treatment and research. Int J Rehabil Res , 1981, 4(4): 483-492.
18.	35 Schünemann HJ, Oxman AD, Vist GE, et al . Cochrane Handbook for Systematic Reviews of Interventionss. In: Higgins JPT, Green S, Cochrane Handbook for Systematic Reviews of Interventions. Version 5.0.1 [updated September 2008]. The Cochrane Collaboration, 2008.
19.	6 Langhorne P, Coupar F, Pollock A. Motor recovery after stroke: a systematic review. Lancet Neurol , 2009, 8(8): 741-754.
20.	Warlow C, Van Gijn J, Sandercock P, et al. Stroke: practical management. Blackwell Pub, 2008.
21.	World Health Organization. World health report 2003. Geneva: World Health Organization, 2003.
22.	吴兆苏, 姚崇华, 赵冬. 我国人群脑卒中发病率、死亡率的流行病学研究. 中华流行病学杂志, 2003, 24(3): 236-239.
23.	World Health Organization. International classification of functioning, disability and health: ICF. Geneva: World Health Organization, 2001.
24.	Wade DT. Measurement in neurological rehabilitation. Oxford University Press, 1992.
25.	World Health Organisation. Cerebrovascular Disorders (Offset Publications). Geneva: World Health Organization, 1978.
26.	中华医学会全国第4次脑血管病学术会议. 各类脑血管病诊断要点. 中华神经科杂志, 1996, 29: 379-381.
27.	符俏, 陈文远, 喻锦成, 等. 运动想象疗法对脑卒中偏瘫患者上肢运动功能的影响. 中国康复医学杂志, 2010, 25(1): 53-55.
28.	胡永新, 王强, 孟萍萍, 等. 运动想象疗法对脑卒中偏瘫患者上肢功能恢复的影响. 中华物理医学与康复杂志, 2010, 32(4): 273-276.
29.	李媛, 沈贵荣, 王强, 等. 运动想像疗法对脑卒中上肢瘫痪病人日常生活活动功能的影响. 青岛大学医学院学报, 2010, 46(3): 244-246.
30.	张谦, 郭根平. "运动想像"疗法对脑卒中偏瘫上肢运动功能恢复的影响. 中国全科医学, 2010, 13(19): 2145-2146.
31.	朱琳, 贾晓红, 刘霖, 等. 运动想象对卒中后偏瘫患者手功能康复的疗效观察. 中国脑血管病杂志, 2009, 6(9): 451-455, 460.
32.	李桥军. 运动想象对脑卒中偏瘫患者上肢运动功能恢复疗效观察. 中国实用医药, 2008, 3(34): 220-221.
33.	王刚, 张德清, 何建永. "运动想像"疗法对脑卒中偏瘫患者上肢功能恢复的影响. 中华物理医学与康复杂志, 2007, 29(11): 759-761.
34.	张洪军. 运动想象联合常规康复治疗对脑损伤偏瘫患者上肢功能障碍恢复的影响. 山东医药, 2007, 47(26): 114-115.
35.	Page SJ. Imagery improves upper extremity motor function in chronic stroke patients: A pilot study. Occupational Therapy Journal of Research, 2000.

1. 7 Duncan PW, Zorowitz R, Bates B, et al . Management of Adult Stroke Rehabilitation Care: a clinical practice guideline. Stroke , 2005, 36(9): e100-e143.
2. 8 Page SJ, Levine P, Leonard AC. Effects of mental practice on affected limb use and function in chronic stroke. Arch Phys Med Rehab , 2005, 86(3): 399-402.
3. 9 Callow N, Hardy L. Types of imagery associated with sport confidence in netball players of varying skill levels. J Appl Sport Psychol , 2001, 13(1): 1-17.
4. 10 Ryan ED, Simons J. Cognitive demand, imagery, and frequency of mental rehearsal as factors influencing acquisition of motor skills. Journal of Sport Psychology , 1981, 3(1): 35-45.
5. 11 Decety J, Jeannerod M, Prablanc C. The timing of mentally represented actions. Behav Brain Res , 1989, 34(1-2): 35-42.
6. 12 Sharma N, Pomeroy VM, Baron JC. Motor imagery: a backdoor to the motor system after stroke? Stroke , 2006, 37(7): 1941-1952.
7. 13 Jackson PL, Lafleur MF, Malouin F, et al . Potential role of mental practice using motor imagery in neurologic rehabilitation. Arch Phys Med Rehab , 2001, 82(8): 1133.
8. 16 Atkins D, Best D, Briss PA, et al . Grading quality of evidence and strength of recommendations. BMJ (Clinical research ed.) , 2004, 328(7454): 1490.
9. 21 Riccio I, Iolascon G, Barillari MR, et al . Mental practice is effective in upper limb recovery after stroke: a randomized single-blind cross-over study. Eur J Phys Rehabil Med , 2010, 46(1): 19-25.
10. 26 Müller K, Butefisch CM, Seitz RJ, et al . Mental practice improves hand function after hemiparetic stroke. Restor Neurol Neurosci , 2007, 25(5-6): 501-511.
11. 27 Page SJ, Levine P, Leonard A. Mental practice in chronic stroke: results of a randomized, placebo-controlled trial. Stroke , 2007, 38(4): 1293-1297.
12. 28 Page SJ, Levine P, Leonard AC. Effects of mental practice on affected limb use and function in chronic stroke. Arch Phys Med Rehab , 2005, 86(3): 399-402.
13. 29 Dijkerman HC, Ietswaart M, Johnston M, et al. Does motor imagery training improve hand function in chronic stroke patients? A pilot study. Clin Rehabil , 2004, 18(5): 538-549.
14. 30 Liu KP, Chan CC, Lee TM, et al . Mental imagery for promoting relearning for people after stroke: a randomized controlled trial. Arch Phys Med Rehabil , 2004, 85(9): 1403-1408.
15. 31 Page SJ, Levine P, Sisto S, et al . A randomized efficacy and feasibility study of imagery in acute stroke. Clin Rehabil , 2001, 15(3): 233-240.
16. 33 Fugl-Meyer AR, Jaasko L, Leyman I, et al . The post-stroke hemiplegic patient. 1. A method for evaluation of physical performance. Scand J Rehabil Med , 1975, 7(1): 13-31.
17. 34 Lyle RC. A performance test for assessment of upper limb function in physical rehabilitation treatment and research. Int J Rehabil Res , 1981, 4(4): 483-492.
18. 35 Schünemann HJ, Oxman AD, Vist GE, et al . Cochrane Handbook for Systematic Reviews of Interventionss. In: Higgins JPT, Green S, Cochrane Handbook for Systematic Reviews of Interventions. Version 5.0.1 [updated September 2008]. The Cochrane Collaboration, 2008.
19. 6 Langhorne P, Coupar F, Pollock A. Motor recovery after stroke: a systematic review. Lancet Neurol , 2009, 8(8): 741-754.
20. Warlow C, Van Gijn J, Sandercock P, et al. Stroke: practical management. Blackwell Pub, 2008.
21. World Health Organization. World health report 2003. Geneva: World Health Organization, 2003.
22. 吴兆苏, 姚崇华, 赵冬. 我国人群脑卒中发病率、死亡率的流行病学研究. 中华流行病学杂志, 2003, 24(3): 236-239.
23. World Health Organization. International classification of functioning, disability and health: ICF. Geneva: World Health Organization, 2001.
24. Wade DT. Measurement in neurological rehabilitation. Oxford University Press, 1992.
25. World Health Organisation. Cerebrovascular Disorders (Offset Publications). Geneva: World Health Organization, 1978.
26. 中华医学会全国第4次脑血管病学术会议. 各类脑血管病诊断要点. 中华神经科杂志, 1996, 29: 379-381.
27. 符俏, 陈文远, 喻锦成, 等. 运动想象疗法对脑卒中偏瘫患者上肢运动功能的影响. 中国康复医学杂志, 2010, 25(1): 53-55.
28. 胡永新, 王强, 孟萍萍, 等. 运动想象疗法对脑卒中偏瘫患者上肢功能恢复的影响. 中华物理医学与康复杂志, 2010, 32(4): 273-276.
29. 李媛, 沈贵荣, 王强, 等. 运动想像疗法对脑卒中上肢瘫痪病人日常生活活动功能的影响. 青岛大学医学院学报, 2010, 46(3): 244-246.
30. 张谦, 郭根平. "运动想像"疗法对脑卒中偏瘫上肢运动功能恢复的影响. 中国全科医学, 2010, 13(19): 2145-2146.
31. 朱琳, 贾晓红, 刘霖, 等. 运动想象对卒中后偏瘫患者手功能康复的疗效观察. 中国脑血管病杂志, 2009, 6(9): 451-455, 460.
32. 李桥军. 运动想象对脑卒中偏瘫患者上肢运动功能恢复疗效观察. 中国实用医药, 2008, 3(34): 220-221.
33. 王刚, 张德清, 何建永. "运动想像"疗法对脑卒中偏瘫患者上肢功能恢复的影响. 中华物理医学与康复杂志, 2007, 29(11): 759-761.
34. 张洪军. 运动想象联合常规康复治疗对脑损伤偏瘫患者上肢功能障碍恢复的影响. 山东医药, 2007, 47(26): 114-115.
35. Page SJ. Imagery improves upper extremity motor function in chronic stroke patients: A pilot study. Occupational Therapy Journal of Research, 2000.

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Efficacy of Mental Practice on Rehabilitation of Hand Function in Patients with Post-stroke: A Systematic Review

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