Home-based graded motor imagery training improves arm function in patients with stroke

This study investigated the effect of home-based graded motor imagery (GMI) training in the treatment of patients with stroke and arm impairment. Researchers suggested that adding GMI training to standard stroke therapy improves arm recovery.

More than 795,000 people in the US have a stroke every year. It happens when the blood flow to the brain stops due to a blood clot or burst blood vessel. The brain cells stop receiving oxygen and begin to die. Brain cells control body functions such as movement. Therefore, a common complication associated with stroke is arm impairment. Treatment programs are necessary to reduce disability in these patients. Most of the recovery is achieved within the first 3 months after stroke. During the chronic phase, the recovery is slow and then reaches a period of stagnation.

Patients with chronic phase stroke may undergo outpatient and community-based treatment programs. However, there are few community programs. GMI was introduced to improve the recovery of stroke patients with complex pain and movement problems. It consists of training the brain away from pain using specific images (imagined or real). Prior studies suggested that GMI improved movements in patients with stroke. However, the effectiveness of GMI within the first 3 months of stroke is still not known.

This study included information about 42 patients with chronic stroke. Patients were assigned to receive conventional therapy alone (group 1) and with GMI training (group 2). GMI training was performed at home for 30 minutes a day over 8 weeks. The main outcome measured was the change in movement before and after GMI training. Activities of daily life were also measured. 

Of the 42 patients first included, 37 completed the 8-week training program (20 in group 1 and 17 in group 2). All patients showed significant improvements in arm function, balance, sensation, and activities of daily living. Despite no significant differences in outcomes were observed between both groups, arm movement in group 2 was significantly better than in group 1.    

This study concluded that the home-based GMI program might be a good treatment option for patients with chronic stroke and arm impairment. 

This study did not determine what types of stroke might benefit the most from GMI training. Further studies are necessary to determine the most suitable strokes for GMI therapy.