This study is an RCT trial investigating a 6 week mental practice intervention phase at 3 Dutch nursing homes in patients in the sub-acute stage of stroke recovery. Mental practice is defined as;
- ‘a training or therapy form in which an internal representation of the movement is activated and the execution of the movement repeatedly mentally simulated, without physical activity, within a chosen context’.
The research examined 4 phases of mental practice implementation; explanation of the imagery to patients; teaching patients how to use imagery; using imagery as part of therapy; facilitating the patient in using it alone and for new tasks. There are some good tips for a team considering setting up a mental practice programme with their stroke patients, and there is discussion around the difficulties encountered. Interesting challenges such as; the intrinsic difficulty in measuring different aspects of the mental practice intervention, knowing if and when a patient has really practiced the imagery within their exercise programme, and getting the timing and vividness of the imagined movement sequence as correct as possible are discussed.
While the overall conclusions are encouraging, in that most patients and therapists are positive about the use of mental imagery, the paper is also refreshingly honest about the difficulties an organised mental practice programme may encounter. The authors conclude that the intervention was less feasible that they had hoped and that implementing a complex therapy delivered by existing multi-professional teams to a vulnerable population of patients with a complex pathology poses many challenges.
These are the challenges that the contemporary multidisciplinary team needs to tackle in the current climate, in order to maximise and promote the patients optimum recovery within the 24 hour approach to rehabilitation.
