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Retention of the spacing effect with mental practice in hemiparetic stroke

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Abstract

Mental practice (MP) is a promising adjuvant to physical practice that involves many of the same mechanisms and takes on many of the same properties as physical practice. This study compared efficacy of a “massed” MP regimen versus a “distributed” MP regimen on upper extremity (UE) motor impairment and functional limitation. Twenty-seven chronic stroke survivors were administered the UE section of the Fugl-Meyer (FM) and Action Research Arm Test (ARAT), followed by standardized physical practice and MP regimens. One group was administered “massed” MP (60 min of MP during a single daily session) and a second group administered distributed MP (20 min of MP occurring three times/day). After intervention, changes in FM and ARAT scores of subjects in the distributed condition were significantly higher than those of subjects in the massed condition (FM 3.65, 95 % CI 0.82–6.49, p value = 0.01; ARAT 3.95, 95 % CI 1.24–6.67, p value = 0.006). Likewise, at POST 3, subjects in the distributed group showed significantly higher change in ARAT scores (ARAT 4.90, 95 % CI 0.57–9.22, p value = 0.03); the change in FM scores at POST 3 was 3.18 points higher among subjects in the distributed condition, but only approached significance (95 % CI −1.27 to 7.63, p value = 0.15). Results suggest that a distributed MP schedule is more efficacious in bringing about paretic UE changes than a massed practice schedule, especially in terms of reducing UE functional limitation.

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Abbreviations

UE:

Upper extremity

ARAT:

Action Research Arm Test

FM:

Fugl-Meyer Impairment Scale

MP:

Mental practice

POST:

After intervention

POST 3:

3 Months after intervention

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Acknowledgments

This work was supported in part by grants from the National Institutes of Health (R21 AT002110-01; KO1 AT002637-05). The authors thank the study coordinators and therapists who assisted with the conduct of this study.

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Authors and Affiliations

  1. B.R.A.I.N. Laboratory (Better Rehabilitation and Assessment for Improved Neuro-recovery), School of Health and Rehabilitation Sciences, The Ohio State University, 453 West Tenth Avenue, Suite 443, Columbus, OH, 43210, USA

    Stephen J. Page

  2. Center for Biostatistics, Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, OH, 43210, USA

    Erinn M. Hade & Juan Pang

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  1. Stephen J. Page
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  2. Erinn M. Hade
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  3. Juan Pang
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Correspondence to Stephen J. Page.

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Page, S.J., Hade, E.M. & Pang, J. Retention of the spacing effect with mental practice in hemiparetic stroke. Exp Brain Res 234, 2841–2847 (2016). https://doi.org/10.1007/s00221-016-4686-5

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  • DOI: https://doi.org/10.1007/s00221-016-4686-5

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