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Neurorehabilitation and Neural Repair
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The Efficacy of Combined Physical and Mental Practice in the Learning of a Foot-Sequence Task after Stroke: A Case Report

Philip L. Jackson

Department of Psychology and Laval University, Quebec City, Canada, Quebec City

Julien Doyon

Laval University, Quebec City, Canada, Quebec City and Department of Psychology, University of Montreal, Montreal, Quebec, Canada

Carol L. Richards

Department of Rehabilitation and Laval University, Quebec City, Canada, Quebec City

Francine Malouin

Centre for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), 525 Hamel Boulevard, Quebec City, Quebec, Canada, G1M 2S8 francine.malouin{at}rea.ulaval.ca

Objective. To investigate the effect of mental practice on the learning of a sequential task for the lower limb in a patient with a hemiparesis resulting from a stroke. Design. A single-case study. Setting. Research laboratory of a university-affiliated rehabilitation center. Patient. A right-handed 38-year-old man who had suffered a left hemorrhagic subcortical stroke 4 months prior. Intervention. The patient practiced a serial response time task with the lower limb in 3 distinct training phases over a period of 5 weeks: 2 weeks of physical practice, 1 week of combined physical and mental practice, and then 2 weeks of mental practice alone. Main Outcome Measures. Performance on the task measured through errors and response times. Imagery abilities measured through questionnaires. Results. The patient’s average response time improved significantly during the 1st 5 days of physical practice (26%) but then failed to show further improvement during the following week of physical practice. The combination of mental and physical practice during the 3rd week yielded additional improvement (10.3%), whereas the following 2 weeks of mental practice resulted in a marginal increase in performance (2.2%). Conclusion. The findings show that mental practice, when combined with physical practice, can improve the performance of a sequential motor skill in people who had a stroke, and suggest that mental practice could play a role in the retention of newly acquired abilities.

Key Words: Motor skill • Learning • Psychomotor performance • Rehabilitation • Stroke • Lower limb

Neurorehabilitation and Neural Repair, Vol. 18, No. 2, 106-111 (2004)
DOI: 10.1177/0888439004265249


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