<ul><li>The Use of Mental Practice in Occupational Therapy for Stroke Patients </li></ul><ul><li>Sarah Freeman </li></ul><...
<ul><li>Definition of mental practice </li></ul><ul><li>Types of mental imagery </li></ul><ul><li>The effectiveness of men...
What is mental practice? <ul><li>‘ the symbolic rehearsal of a physical activity in the absence of any gross muscular move...
Types of mental imagery <ul><li>Visual   </li></ul><ul><ul><li>eg Imagining the movement of a visual form </li></ul></ul><...
<ul><li>Internal Imagery-  an internal recreation of the task:  </li></ul><ul><li>Effective for planning a task </li></ul>...
The effectiveness of mental practice <ul><li>Combined with physical practice,  </li></ul><ul><li>mental practice: </li></u...
Stroke rehabilitation approaches <ul><li>All approaches involve the process of re-learning </li></ul><ul><li>Eg: </li></ul...
Mental practice theories <ul><li>It is debated whether mental practice relies on motor, cognitive or motivational processe...
How mental imagery can promote functional independence through relearning
Mental practice used in occupational therapy <ul><li>Page, Levine & Leonard (2005)   </li></ul><ul><li>Investigated the ef...
Mental practice used in occupational therapy <ul><li>Page, Levine & Leonard (2005)   </li></ul><ul><li>Results showed: </l...
Mental practice used in occupational therapy <ul><li>Smania, et al. (1997)   </li></ul><ul><li>Studied the effectiveness o...
Mental practice used in occupational therapy <ul><li>Smania, et al. (1997)   </li></ul><ul><li>Outcomes assessed using fun...
Mental practice used in occupational therapy <ul><li>Liu et al., (2004)   </li></ul><ul><li>Studied the efficacy of mental...
Mental practice used in occupational therapy <ul><li>Liu et al., (2004)   </li></ul><ul><li>Outcome measures used were the...
Benefits of using mental practice <ul><ul><li>Increases affected limb use and function </li></ul></ul><ul><ul><li>Can impr...
Areas for further research <ul><li>Establishing guidelines and protocols </li></ul><ul><li>Motivational aspects of relearn...
<ul><li>Sarah Freeman </li></ul><ul><li>[email_address] </li></ul>Mental Practice
References <ul><li>Bell, A. & Murray, B (2004)  Improvement in Upper Limb Motor Performance following Stroke: the Use of M...
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Mental-practice-in-OT-Stroke-LLL event-London region. freeman.pp.ppt

  1. 1. <ul><li>The Use of Mental Practice in Occupational Therapy for Stroke Patients </li></ul><ul><li>Sarah Freeman </li></ul><ul><li>[email_address] </li></ul>Mental Practice
  2. 2. <ul><li>Definition of mental practice </li></ul><ul><li>Types of mental imagery </li></ul><ul><li>The effectiveness of mental practice </li></ul><ul><li>The use of mental practice in stroke rehabilitation and in occupational therapy </li></ul><ul><li>Areas for further research </li></ul>Objectives
  3. 3. What is mental practice? <ul><li>‘ the symbolic rehearsal of a physical activity in the absence of any gross muscular movements’ (Richardson, 1967) </li></ul><ul><li>Mental practice is achieved through the use of mental imagery </li></ul><ul><li>The effects of mental and physical practice are functionally similar </li></ul>
  4. 4. Types of mental imagery <ul><li>Visual </li></ul><ul><ul><li>eg Imagining the movement of a visual form </li></ul></ul><ul><li>Motor </li></ul><ul><ul><li>eg imagining your own hand moving </li></ul></ul><ul><li>Kinaesthetic </li></ul><ul><ul><li>eg imagining the feeling of your hand moving </li></ul></ul>
  5. 5. <ul><li>Internal Imagery- an internal recreation of the task: </li></ul><ul><li>Effective for planning a task </li></ul><ul><li>External Imagery- an outside perspective of performance: </li></ul><ul><li>More effective for learning & subsequent retention </li></ul>Types of mental imagery
  6. 6. The effectiveness of mental practice <ul><li>Combined with physical practice, </li></ul><ul><li>mental practice: </li></ul><ul><li>improves performance to the same, or a higher extent than physical practice alone </li></ul><ul><li>increases the rate of skill acquisition </li></ul><ul><li>may facilitate greater performance than that of a control condition of no input </li></ul>
  7. 7. Stroke rehabilitation approaches <ul><li>All approaches involve the process of re-learning </li></ul><ul><li>Eg: </li></ul><ul><ul><li>Neurodevelopmental treatment (Bobath) </li></ul></ul><ul><ul><li>Motor re-learning (Carr & Shepherd) </li></ul></ul><ul><ul><li>Task- oriented approaches </li></ul></ul><ul><ul><li>Compensatory </li></ul></ul>
  8. 8. Mental practice theories <ul><li>It is debated whether mental practice relies on motor, cognitive or motivational processes </li></ul><ul><ul><li>Mental practice is more effective when learning simple tasks </li></ul></ul><ul><ul><li>Imagery abilities may vary </li></ul></ul><ul><ul><li>Tasks learned must be meaningful & prior experience of the activity is necessary </li></ul></ul>
  9. 9. How mental imagery can promote functional independence through relearning
  10. 10. Mental practice used in occupational therapy <ul><li>Page, Levine & Leonard (2005) </li></ul><ul><li>Investigated the efficacy of mental practice in increasing the function & use of the affected upper limb of 11 stroke patients. </li></ul><ul><li>Randomized, controlled pre-post case series study </li></ul><ul><li>Tasks were reaching & grasping a cup, turning pages & using a pen. </li></ul>
  11. 11. Mental practice used in occupational therapy <ul><li>Page, Levine & Leonard (2005) </li></ul><ul><li>Results showed: </li></ul><ul><ul><li>Increased affected limb use and function </li></ul></ul><ul><ul><li>Skills had been generalized to other ADLs after intervention </li></ul></ul>
  12. 12. Mental practice used in occupational therapy <ul><li>Smania, et al. (1997) </li></ul><ul><li>Studied the effectiveness of visuomotor imagery practice in rehabilitation of unilateral neglect </li></ul><ul><li>Before / after trial on 2 participants </li></ul><ul><li>Mental imagery included imagining patients at home, geographical areas, reverse spelling & mental representation. </li></ul>
  13. 13. Mental practice used in occupational therapy <ul><li>Smania, et al. (1997) </li></ul><ul><li>Outcomes assessed using functional tests & neuropsychological tests </li></ul><ul><li>Visuomotor imagery training found to improve performance deficits related to neglect </li></ul>
  14. 14. Mental practice used in occupational therapy <ul><li>Liu et al., (2004) </li></ul><ul><li>Studied the efficacy of mental imagery at promoting relearning for people after a stroke </li></ul><ul><li>Prospective, randomized controlled trial, of 46 stroke inpatients aged over 60 years. </li></ul><ul><li>MP Protocol used picture cards, visualizing performance and watching videotaped performance </li></ul>
  15. 15. Mental practice used in occupational therapy <ul><li>Liu et al., (2004) </li></ul><ul><li>Outcome measures used were the performance of 15 trained and 5 untrained daily living tasks </li></ul><ul><li>Patients who engaged in mental practice improved their attention & sequencing ability </li></ul><ul><li>Increased their relearning of familiar and new tasks </li></ul>
  16. 16. Benefits of using mental practice <ul><ul><li>Increases affected limb use and function </li></ul></ul><ul><ul><li>Can improve cognitive skills (eg attention, sequencing) </li></ul></ul><ul><ul><li>Creates opportunities for clients to problem-solve </li></ul></ul><ul><ul><li>Uses a client-centred approach </li></ul></ul><ul><ul><li>Time / cost -effective </li></ul></ul>
  17. 17. Areas for further research <ul><li>Establishing guidelines and protocols </li></ul><ul><li>Motivational aspects of relearning through mental practice </li></ul><ul><li>Long-term occupational benefits </li></ul>
  18. 18. <ul><li>Sarah Freeman </li></ul><ul><li>[email_address] </li></ul>Mental Practice
  19. 19. References <ul><li>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. </li></ul><ul><li>Kosslyn,S.M. (1994) Image and brain : the resolution of the imagery debate. Cambridge, Mass. ; London : MIT Press </li></ul><ul><li>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. </li></ul><ul><li>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. </li></ul><ul><li>Richardson, A (1967) Mental Practice: a review and discussion (part 1). Research Quarterly (38): 95-107 </li></ul><ul><li>Smania, N., Bazoli, .F, Piva, D., Guidetti, G. (1997) Visuomotor imagery and rehabilitation of neglect. Archives of Physical & Medical Rehabilitation, 78:430-6. </li></ul><ul><li>Van Leeuwen, R., Inglis, J.T. (1998) Mental practice and imagery: a potential in stroke rehabilitation. Physical Therapy Reviews 3 :47-52. </li></ul>

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