Proposed Topic (Most preferred): :
Clinical Safety and Quality Service II (Projects aiming to enhance clinical safety and outcomes, clinical governance / risk management)
Proposed Topic (Second preferred): :
Clinical Safety and Quality Service III (Projects aiming at quality service to patients and their carers)
Authors (including presenting author) :
Chan PC, Wan CT, Li WW, Tsoi YN, Pak KH, So CT, Wong YCJ
Affiliation :
Occupational Therapy Department, Lai King Building, Princess Margaret Hospital
Introduction :
Motor impairment is the most common and widely recognized impairment caused by neurological disease. Upper limb function impairment is often a major result seen in patients with CVA. Mental imagery (MI) is the mental rehearsal of a movement without performing the actual movement (Decety, 1996). It is generally held that there is brain activation after mental imagery. Multiple functional imaging studies have proven that mental practice with mental imagery leads to activation of motor-related brain regions (Butler and Page, 2006). The COVID-19 pandemic has inspired therapists to explore more modalities of treatment for CVA patients to facilitate rehabilitation effectiveness.
Objectives :
This study aims to evaluate the effectiveness of mental imagery as an adjunctive therapy in improving upper limb function for patients with Cerebrovascular Accident (CVA) attending the Geriatric Day Hospital (GDH) in Lai King Building from November 2023 to February 2024. The intervention was prescribed as home program.
Methodology :
This is a randomized controlled study with newly diagnosed CVA patients actively attending the Geriatric Day Hospital. Upper limb function assessments were performed for both groups on days 0 and 28. After the baseline assessment, participants were randomly allocated into two groups - experimental and control. Randomization performed by using a computer-generated system. In the control group, patients received conventional stroke rehabilitation by occupational therapists (OT) along with a daily 30-minute usual upper limb home program prescribed by case therapists. The home program content was demonstrated during GDH sessions and then self-practice at home. For the experimental group, as an adjunctive treatment, participants received a video of mental imagery to guide their self-practice at home. The videos consisted of 4 movement-based tasks and 3 activities of daily living. The treatment regimen was set as 2 sessions (~30 minutes) per day for 4 weeks.
Result & Outcome :
The primary outcome measures of the study included the Wolf Motor Function Test (WMFT) and the Action Research Arm Test (ARAT). The Hong Kong version of the Functional Test for the Hemiplegic Upper Extremity (FTHUE-HK) and the Modified Barthel Index were used as secondary outcome measurements. Since November 2023, 18 GDH cases have been recruited for the program with one dropped out. Subjects in the experimental group showed a more statistically significant improvement in hand function and self-care, comparing to control group. Improvement in assessment result was observed for both group with treatment group greater in change. Mental Imagery may be an effective adjunctive treatment in stroke rehabilitation for improving hand function. Ongoing subject recruitment is required for a more detailed analysis on treatment effectiveness.
