Researchers from the University of Toronto, in Ontario have reviewed the contributions of cognitive strategies for improving muscle function (motor skills) after stroke.

First, the details.

• 26 articles were reviewed.
• 7 studies investigated general cognitive strategies.
• 19 investigated task-specific strategies.

And, the results.

• The most commonly studied task-specific strategy was motor imagery.
• Motor imagery (commonly used in sport training) is a mental process by which a person rehearses or simulates a given action.
• General strategy training (designed to compensate for the inability to move part of the body) improved performance in both trained and untrained activities compared to traditional physiotherapy.
• Motor imagery improved mobility and recovery in the affected upper extremity in people living with the chronic effects of stroke.

The bottom line?
The information available in the abstract of this review is limited. However, other sources help fill in the details.

Dr. Milton Dehn, at Schoolhouse Educatonal Services in Wisconsin, states, “In general, strategy training should be explicit and intensive over an extended period of time until strategy use becomes automatic.”

Last year, researchers from Switzerland conducted a review of motor imagery in post-stroke rehabilitation and agreed, “There is modest evidence supporting the additional benefit of motor imagery compared to only conventional physiotherapy in patients with stroke.

• In 3 studies, there were positive effects of muscular movement on the ARAT and the FMSA.
• ARAT (Action Research Arm Test) measures muscular movement (grasp, grip, pinch, and gross movements) after stroke.
• FSMA (Fugl-Meyer Stroke Assessment) measures muscular movement, reflexes, coordination and speed.
• 1 study showed significant improvement in completing tasks.

Unanswered questions include the best time to start motor imagery and the optimal duration of treatment. Also, the effect of patients’ motivation on outcomes isn’t known.

5/4/09 13:46 JR