Have you used mental imagery as part of your rehab?

Great conversation Diana and Heather, such exciting research. This is a treatment technique I'm very passionate about and mental practice or guided imagery is gaining more and more evidence for it's use in stroke rehabilitation. The thing I love about it is it's free and everyone (almost everyone if taught properly and can follow instructions) can do it outside of therapy. It has been around for a long time in other areas like sports psychology - think of Olympic athletes visualising winning an event or jumping over the hurdles or a tennis champion visualising hitting the ball, serving and playing a successful shot. It's a really exciting and interesting area linked to neuroplasticity and the wonder that is the brain!

It's also in our clinical guidelines on page 87 and page 95. The references for it can be found at the back of the guidelines reference 548 and 662.
http://strokefoundation.com.au/site/media/Clinical-Guidelines-Acute-Rehab-Management-2010-Interactive.pdf

It is so wonderful to hear you have a lived experience of it Heather and that it works so well for you. I think it's a technique that in practice in hospital settings isn't used nearly enough.

Simone (Occupational Therapist for StrokeLine ph: 1800 787 653)

Mental practice (or imagery) - yes its 'free' and low cost' but its not just about thinking about/imaging yourself doing a task from time to time. the studies that have shown benefits have a very structured protocol that people follow, for example, you close your eyes and imagine the process of opening your hand and sliding your arm forward to reach for a cup. You then actually physically practice the same task. You continue and alternate mental practice with actual practice for 5-10 minutes, a couple of times a day. Its not generally useful for people with NO actual movement because they cannot move after their mental practice attempt (although its not harmful for such people to use mental practice - just hard to do because they often see not change in their arm function). Therapists are getting more familiar with what they should be teaching and how to assist stroke survivors - but its important to know that this treatment involves MUCH more than just 'thinking about the movement' from time to time.

I have no movement or sensory in my left hand. I use mental imagery where I touch my thumb to each of my other fingers slowly so although I cannot move it I can still recognise what muscles etc I should be using. I use a one handed typing software but am still conscious to not lose the movement or recognition of typing with my left hand. It’s hard but my neuro physio as well as constant persistence has kept that imagery even though I’ve no movement at all with my left hand.

Hi everyone, good subject!

Annie., in regards to someone who cannot move, a paragraph in the link Diana provided says "One of these treatments is really intense physical therapy, but some people can't move at all. We found in our data that if they just think about moving, it keeps the neurons active right around the area that died in the brain. We used mental practice as a primer for physical training. As people improve and move along in their rehabilitation, they can progress from mental practice to physical practice and this can result in behavioral change, meaning they could move their arms better."

I lost use of my left side and whilst I was regaining use of my arm initially, nothing was happening, it seemed, with my leg. However I was so determined to recover that I used a fair bit of mental imagery and mental practise, I guess you could say. I thought - a lot - about moving, even imagining little creatures (Pacman & friends, actually!!) zooming through my veins and arteries, clearing them as they went, as in the early days, even though I'd had a haemorrhagic stroke and knew it wasn't a clot, tests for cholesterol, brain tumour etc, were still to come back. All my tests were eventually found to be in the normal-good range and no medical reason was found for the stroke however that didn't stop me visualising in this way with my little Pacmen!

In fact I would go so far as to say that a lot of my hospital time, when there weren't any visitors, medical staff calling by, tests, mealtimes, etc, I used this mental practise (and some meditation). I swung between sleeping at the drop of a hat or not sleeping, and often I would wake in the night so spent every chance I had really focussing on healing and regaining and attempting to do things that I knew my body actually could not do. I began this on Day 1, even whilst in the emergency department at hospital. :)

Some feeling returned to my leg, along with a sense that I could have a smidgeon of control over it and I could make it walk, albeit with walkers and a helper. Was it because of what I did or would it have been a natural progression over time, I'm not sure. But I couldn't lay there and do nothing and I sense/believe/know intuitively that it helped me a lot.