Home-Based Motor Imagery Training for Gait Rehabilitation of People With Chronic Poststroke Hemiparesis

• DOI: 10.1016/j.apmr.2007.12.039
• Publication Date: 2008-07-31T12:56:32Z
• Authors: Ayelet Dunsky; Ruth Dickstein; Emanuel Marcovitz; Sandra Levy; Judith Deutsch
• Keywords: Adult; Male; Imagery, Psychotherapy; Knee Joint; Disability Evaluation; 03 medical and health sciences; 0302 clinical medicine; Humans; Range of Motion, Articular; Gait Disorders, Neurologic; Aged; Analysis of Variance; Recovery of Function; Middle Aged; 16. Peace & justice; Home Care Services; Biomechanical Phenomena; 3. Good health; Paresis; Stroke; Chronic Disease; Feasibility Studies; Female; Ankle Joint

To test the feasibility and efficacy of a home-based motor imagery gait training program to improve walking performance of individuals with chronic poststroke hemiparesis.Nonrandomized controlled trial.Local facility.Participants (N=17) were community-dwelling volunteers with hemiparesis caused by a unilateral stroke that occurred at least 3 months before the study.Participants received 15 minutes of supervised imagery gait training in their homes 3 days a week for 6 weeks. The intervention addressed gait impairments of the affected lower limb and task-specific gait training. Walking ability was evaluated by kinematics and functional scales twice before the intervention, 3 and 6 weeks after the intervention began, and at the 3-week follow-up.Spatiotemporal, kinematic, and functional walking measurements.Walking speed increased significantly by 40% after training, and the gains were largely maintained at the 3-week follow-up. The effect size of the intervention on walking speed was moderate (.64). There were significant increases in stride length, cadence, and single-support time of the affected lower limb, whereas double-support time was decreased. Improvements were also noted on the gait scale of the Tinetti Performance-Oriented Mobility Assessment as well as in functional gait. Sixty-five percent of the participants advanced 1 walking category in the Modified Functional Walking Categories Index.Although further study is recommended, the findings support the feasibility and justify the incorporation of home-based motor imagery exercises to improve walking skills for poststroke hemiparesis.