Researchers from the Oxford Brookes University in the United Kingdom investigated the feasibility of integrating a motor imagery program into a treatment regimen of physiotherapy and occupational therapy for patients diagnosed with stroke, brain injury or multiple sclerosis.

Thirty inpatients and outpatients in treatment at a neurologic rehabilitation center participated in the study. A parallel-group, phase II, assessor-blind randomized controlled trial compared motor imagery embedded in treatment as usual with treatment as usual only. Subjects were assessed at baseline, after 6 weeks (post-intervention), and after 12 weeks (follow-up).

A motor imagery strategy was developed and integrated into treatment as usual (physiotherapy and occupational therapy) which was tailored to individual goals, and applied to any activity. The control group received standard care (physiotherapy and occupational therapy).

Goal attainment scaling was used as the primary outcome measure. Other measures included the Barthel activities of daily living index and the Rivermead Mobility Index.

Compliance with advised treatment was poor in 85% of the therapists and in 72% of the patients. Goal attainment scaling scores significantly improved at post-intervention and follow-up [F(2,27)=45.159; P<.001], but no significant difference was observed between the groups over time [F(1,28)=.039; P=.845].

Therapist and patient compliance with performing the intervention was low, restricting the conclusions regarding the effectiveness of the integrated motor imagery program. Future studies will need to explore barriers and facilitators to uptake of this intervention in clinical practice. Trial recruitment and retention were good. The study demonstrated that imagery could be successfully integrated into usual therapy and tailored for a wide range of functional activities.

Citation:  Bovend'Eerdt TJ, Dawes H, Sackley C, Izadi H, Wade DT. An integrated motor imagery program to improve functional task performance in neuro-rehabilitation: a single-blind randomized controlled trial. Archives of Physical Medicine and Rehabilitation. 2010 Jun;91 (6): pages 939-46. [email protected]