Nilsen, D., M., Gillen, G., & Gordon, A. M. (2010). Use of mental practice to improve upper-limb recovery after stroke: A systematic review. American Journal of Occupational Therapy, 64, 695-708.

Nilsen, Gillen & Gordon (2010) conducted a systematic review of the efficacy of mental practice in improving upper limb recovery among patients with stroke (N=145). Relevant studies available in English were drawn from multiple databases from 1985 to February 2009. The review comprised a total of 15 studies (4 RCTs, 2 controlled clinical trials, 1 pre-post single-group study, 7 case series/case studies and 1 single-case experimental multiple baseline study). All studies excluding 3 case studies are included and reviewed on StrokEngine. Among the 15 studies, stage of recovery from stroke ranged from 10 days to 174 months. Mean age of participants ranged from 24 years to 81 years. Intervention protocol varied among studies, although most combined mental practice and physical practice. The comparison intervention included physical practice, CIMT, non-motor imagery or conventional rehabilitation. Frequency and duration of treatment ranged from 10-minute to 3-hour sessions, daily to twice/week, for 2 to 8 weeks. Outcomes of upper extremity function or recovery were typically measured by the Fugl-Meyer Assessment, Motricity Index, Action Research Arm Test, or Jebsen hand function test. The conclusion indicated that mental imagery performed in conjunction with physical practice is more effective than physical practice alone or conventional rehabilitation alone. Mental imagery is effective in reducing impairment and improving functional recovery. There is also evidence to indicate that mental imagery may be effective in improving perceived use and quality of movement of the upper limb.