MentalPractice-Occupationaltherapy-helpingyoutolivelife精神实践职业疗法帮助你的生活.ppt

The Use of Mental Practice in Occupational Therapy for Stroke Patients Sarah Freeman sarahsarahfreeman.co.uk,Mental Practice,Definition of mental practice Types of mental imagery The effectiveness of mental practice The use of mental practice in stroke rehabilitation and in occupational therapy Areas for further research,Objectives,What is mental practice?,the symbolic rehearsal of a physical activity in the absence of any gross muscular movements (Richardson, 1967) Mental practice is achieved through the use of mental imagery The effects of mental and physical practice are functionally similar,Types of mental imagery,Visual eg Imagining the movement of a visual form Motor eg imagining your own hand moving Kinaesthetic eg imagining the feeling of your hand moving,Internal Imagery- an internal recreation of the task: Effective for planning a task External Imagery- an outside perspective of performance: More effective for learning & subsequent retention,Types of mental imagery,The effectiveness of mental practice,Combined with physical practice, mental practice: improves performance to the same, or a higher extent than physical practice alone increases the rate of skill acquisition may facilitate greater performance than that of a control condition of no input,Stroke rehabilitation approaches,All approaches involve the process of re-learning Eg: Neurodevelopmental treatment (Bobath) Motor re-learning (Carr & Shepherd) Task- oriented approaches Compensatory,Mental practice theories,It is debated whether mental practice relies on motor, cognitive or motivational processes Mental practice is more effective when learning simple tasks Imagery abilities may vary Tasks learned must be meaningful & prior experience of the activity is necessary,How mental imagery can promote functional independence through relearning,Mental practice used in occupational therapy,Page, Levine & Leonard (2005) Investigated the efficacy of mental practice in increasing the function & use of the affected upper limb of 11 stroke patients. Randomized, controlled pre-post case series study Tasks were reaching & grasping a cup, turning pages & using a pen.,Mental practice used in occupational therapy,Page, Levine & Leonard (2005) Results showed: Increased affected limb use and function Skills had been generalized to other ADLs after intervention,Mental practice used in occupational therapy,Smania, et al. (1997) Studied the effectiveness of visuomotor imagery practice in rehabilitation of unilateral neglect Before / after trial on 2 participants Mental imagery included imagining patients at home, geographical areas, reverse spelling & mental representation.,Mental practice used in occupational therapy,Smania, et al. (1997) Outcomes assessed using functional tests & neuropsychological tests Visuomotor imagery training found to improve performance deficits related to neglect,Mental practice used in occupational therapy,Liu et al., (2004) Studied the efficacy of mental imagery at promoting relearning for people after a stroke Prospective, randomized controlled trial, of 46 stroke inpatients aged over 60 years. MP Protocol used picture cards, visualizing performance and watching videotaped performance,Mental practice used in occupational therapy,Liu et al., (2004) Outcome measures used were the performance of 15 trained and 5 untrained daily living tasks Patients who engaged in mental practice improved their attention & sequencing ability Increased their relearning of familiar and new tasks,Benefits of using mental practice,Increases affected limb use and function Can improve cognitive skills (eg attention, sequencing) Creates opportunities for clients to problem-solve Uses a client-centred approach Time / cost -effective,Areas for further research,Establishing guidelines and protocols Motivational aspects of relearning through mental practice Long-term occupational benefits,Sarah Freeman sarahsarahfreeman.co.uk,Mental Practice,References,Bell, A. London : MIT Press Liu, K. P., Chan, C. C., Lee, T., Hui-Chan, C. W. (2004) Mental Imagery for Promoting Relearning for People After Stroke: A Randomized Controlled Trial. Archives of Physical Medical Rehabilitation 85:1403-8. Page, S. Levine, P. Leonard, A. (2005) Effects of Mental Practice on Affected Limb Use and Function in Chronic Stroke. Archives of Physical & Medical Rehabilitation 86 399-402. Richardson, A (1967) Mental Practice: a review and discussion (part 1). Research Quarterly (38): 95-107 Smania, N., Bazoli, .F, Piva, D., Guidetti, G. (1997) Visuom