Effectiveness of first-person and third-person motor imagery in relearning daily hand tasks in people with stroke living in the community

Abstract

Stroke is the leading cause of adult disability worldwide, and the number of people with disability following stroke is rapidly increasing. Currently, there are several approaches used in stroke rehabilitation. Research suggests that therapy should be task-specific and repetitive to enhance neural plasticity enabling sensory-motor function. Furthermore, a need for easily applicable and cost-effective techniques for stroke rehabilitation is also recognised. Motor imagery (MI) has been identified as a potential technique to enhance motor recovery following stroke. When practising MI, one can utilise either the First-Person Motor Imagery (FPMI) or Third-Person Motor Imagery (TPMI). However, the specific effects of the two different perspectives have not been investigated previously, on people with stroke living in the community. Therefore, this PhD aimed to address the above gap in the literature and for the clinical practice. The objectives of this research were threefold, that is, to investigate whether; 1) the FPMI and TPMI intervention programs enhance performance-based upper extremity and hand function, self-perceived upper extremity and hand function, self-perceived daily functions and quality of life in comparison to a conventional occupational therapy program (active control); 2) the FPMI intervention program was more effective in improving performance-based upper extremity and hand function in comparison to the TPMI and active control programs; and 3) the TPMI intervention program was more effective in enhancing self-perceived upper extremity and hand function, self-perceived daily functions and quality of life in comparison to the FPMI and active control programs. This study revealed that both the FPMI and TPMI interventions were equally effective and significantly better in enhancing performance-based upper extremity and hand function in comparison to the active control group. Both the FPMI and TPMI groups showed a further improvement in self-perceived upper extremity and hand function than the active control group and the TPMI group showed improvement in upper extremity function than the FPMI group at follow up. In addition, the TPMI group showed a long-term improvement in quality of life. Although, there was no significant group difference in daily functions in the tree groups, analysis of within group data showed improved daily functions in all groups. These results suggest that when the rehabilitation professionals aim to enhance upper extremity function, either the FPMI or TPMI can be used. However, when the key focus is enhancing quality of life, using TPMI seems to be a better option.

Date of Award	2021
Original language	English