A randomized efficacy and feasibility study of imagery in acute stroke

OBJECTIVE: To compare the feasibility and efficacy of a programme combining imagery and occupational therapy with a programme of therapy only. DESIGN: Randomized, controlled case series. SETTING: Subacute outpatient clinic. SUBJECTS: Thirteen consecutively admitted patients between four weeks and one year post stroke exhibiting stable motor deficits in their affected upper limbs. INTERVENTION: All patients received an hour of therapy three times a week for six weeks administered by the same physical and occupational therapists. During the same period, eight patients participated in 10-minute guided imagery sessions after each therapy session, as well as practising imagery at home twice each week. Five patients participated in a control intervention consisting of exposure to stroke information. MAIN OUTCOME MEASURES: The Fugl-Meyer Assessment of Motor Recovery (Fugl-Meyer) and Action Research Arm Test (ARA). RESULTS: After intervention, Fugl-Meyer and ARA scores of patients in the therapy only group remained virtually the same; therapy plus imagery group scores improved by 13.8 and 16.4 points, respectively, on the Fugl-Meyer and ARA. CONCLUSIONS: Imagery is a clinically feasible, cost-effective complement to therapy that may improve outcomes more than participation in therapy only.