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Effects of mental practice embedded in daily therapy compared to therapy as usual in adult stroke patients in Dutch nursing homes: design of a randomised controlled trial.

Braun SM, Beurskens AJ, van Kroonenburgh SM, Demarteau J, Schols JM, Wade DT - BMC Neurol (2007)

Bottom Line: The primary outcome measure is the patient-perceived effect on performance of daily activities as assessed by an 11-point Likert Scale.Advantages and disadvantages of several aspects of the chosen design are discussed.ISRCTN27582267.

View Article: PubMed Central - HTML - PubMed

Affiliation: The centre of expertise in life sciences, Zuyd University, Heerlen, The Netherlands. s.braun@hszuyd.nl

ABSTRACT

Background: Mental practice as an additional cognitive therapy is getting increased attention in stroke rehabilitation. A systematic review shows some evidence that several techniques in which movements are rehearsed mentally might be effective but not enough to be certain. This trial investigates whether mental practice can contribute to a quicker and/or better recovery of stroke in two Dutch nursing homes. The objective is to investigate the therapeutic potential of mental practice embedded in daily therapy to improve individually chosen daily activities of adult stroke patients compared to therapy as usual. In addition, we will investigate prognostic variables and feasibility (process evaluation).

Methods: A randomised, controlled, observer masked prospective trial will be conducted with adult stroke patients in the (sub)acute phase of stroke recovery. Over a six weeks intervention period the control group will receive multi professional therapy as usual. Patients in the experimental group will be instructed how to perform mental practice, and will receive care as usual in which mental practice is embedded in physical, occupation and speech therapy sessions. Outcome will be assessed at six weeks and six months. The primary outcome measure is the patient-perceived effect on performance of daily activities as assessed by an 11-point Likert Scale. Secondary outcomes are: Motricity Index, Nine Hole Peg Test, Barthel Index, Timed up and Go, 10 metres walking test, Rivermead Mobility Index. A sample size of the patients group and all therapists will be interviewed on their opinion of the experimental program to assess feasibility. All patients are asked to keep a log to determine unguided training intensity.

Discussion: Advantages and disadvantages of several aspects of the chosen design are discussed.

Trial registration: ISRCTN27582267.

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Related in: MedlinePlus

Overview of mental practice training phases and their aims. * at least 3 times 10 minutes a day. Preferably, mental practice is combined with physical or occupational therapy or the overt movement at lunch time. Time spend on mental practice unguided can be increased considerable due to compliance/motivation of the patient to practice. Training data are recorded in a personal log (diary) preferably by the patient or assisted by a member of the family or therapist/nurse.
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Figure 2: Overview of mental practice training phases and their aims. * at least 3 times 10 minutes a day. Preferably, mental practice is combined with physical or occupational therapy or the overt movement at lunch time. Time spend on mental practice unguided can be increased considerable due to compliance/motivation of the patient to practice. Training data are recorded in a personal log (diary) preferably by the patient or assisted by a member of the family or therapist/nurse.

Mentions: The experimental intervention period is divided into four phases (fig. 2). In the first sessions, patients will first be familiarised with mental practice-based therapy and educated by their treating therapists as to basic imagery principles and the importance of imagery training on a regular basis (phase 1). There is some evidence that patients educated on and familiarised with the technique are more likely to practice in general and to practice correctly by themselves [22-24].


Effects of mental practice embedded in daily therapy compared to therapy as usual in adult stroke patients in Dutch nursing homes: design of a randomised controlled trial.

Braun SM, Beurskens AJ, van Kroonenburgh SM, Demarteau J, Schols JM, Wade DT - BMC Neurol (2007)

Overview of mental practice training phases and their aims. * at least 3 times 10 minutes a day. Preferably, mental practice is combined with physical or occupational therapy or the overt movement at lunch time. Time spend on mental practice unguided can be increased considerable due to compliance/motivation of the patient to practice. Training data are recorded in a personal log (diary) preferably by the patient or assisted by a member of the family or therapist/nurse.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2169252&req=5

Figure 2: Overview of mental practice training phases and their aims. * at least 3 times 10 minutes a day. Preferably, mental practice is combined with physical or occupational therapy or the overt movement at lunch time. Time spend on mental practice unguided can be increased considerable due to compliance/motivation of the patient to practice. Training data are recorded in a personal log (diary) preferably by the patient or assisted by a member of the family or therapist/nurse.
Mentions: The experimental intervention period is divided into four phases (fig. 2). In the first sessions, patients will first be familiarised with mental practice-based therapy and educated by their treating therapists as to basic imagery principles and the importance of imagery training on a regular basis (phase 1). There is some evidence that patients educated on and familiarised with the technique are more likely to practice in general and to practice correctly by themselves [22-24].

Bottom Line: The primary outcome measure is the patient-perceived effect on performance of daily activities as assessed by an 11-point Likert Scale.Advantages and disadvantages of several aspects of the chosen design are discussed.ISRCTN27582267.

View Article: PubMed Central - HTML - PubMed

Affiliation: The centre of expertise in life sciences, Zuyd University, Heerlen, The Netherlands. s.braun@hszuyd.nl

ABSTRACT

Background: Mental practice as an additional cognitive therapy is getting increased attention in stroke rehabilitation. A systematic review shows some evidence that several techniques in which movements are rehearsed mentally might be effective but not enough to be certain. This trial investigates whether mental practice can contribute to a quicker and/or better recovery of stroke in two Dutch nursing homes. The objective is to investigate the therapeutic potential of mental practice embedded in daily therapy to improve individually chosen daily activities of adult stroke patients compared to therapy as usual. In addition, we will investigate prognostic variables and feasibility (process evaluation).

Methods: A randomised, controlled, observer masked prospective trial will be conducted with adult stroke patients in the (sub)acute phase of stroke recovery. Over a six weeks intervention period the control group will receive multi professional therapy as usual. Patients in the experimental group will be instructed how to perform mental practice, and will receive care as usual in which mental practice is embedded in physical, occupation and speech therapy sessions. Outcome will be assessed at six weeks and six months. The primary outcome measure is the patient-perceived effect on performance of daily activities as assessed by an 11-point Likert Scale. Secondary outcomes are: Motricity Index, Nine Hole Peg Test, Barthel Index, Timed up and Go, 10 metres walking test, Rivermead Mobility Index. A sample size of the patients group and all therapists will be interviewed on their opinion of the experimental program to assess feasibility. All patients are asked to keep a log to determine unguided training intensity.

Discussion: Advantages and disadvantages of several aspects of the chosen design are discussed.

Trial registration: ISRCTN27582267.

Show MeSH
Related in: MedlinePlus