MentalPracticeOccupationaltherapyhelpingyoutolivelife精神實踐職業(yè)療法幫助你的生活課件

1、The Use of Mental Practice in Occupational Therapy for Stroke PatientsSarah Freemansarahsarahfreeman.co.ukMental Practice第1頁，共19頁。Definition of mental practiceTypes of mental imageryThe effectiveness of mental practiceThe use of mental practice in stroke rehabilitation and in occupational therapyAre

2、as for further researchObjectives第2頁，共19頁。What is mental practice?the symbolic rehearsal of a physical activity in the absence of any gross muscular movements (Richardson, 1967)Mental practice is achieved through the use of mental imageryThe effects of mental and physical practice are functionally s

3、imilar第3頁，共19頁。Types of mental imageryVisual eg Imagining the movement of a visual formMotoreg imagining your own hand movingKinaestheticeg imagining the feeling of your hand moving第4頁，共19頁。Internal Imagery- an internal recreation of the task: Effective for planning a taskExternal Imagery- an outsid

4、e perspective of performance:More effective for learning & subsequent retentionTypes of mental imagery第5頁，共19頁。The effectiveness of mental practiceCombined with physical practice, mental practice:improves performance to the same, or a higher extent than physical practice alone increases the rate of

5、skill acquisitionmay facilitate greater performance than that of a control condition of no input第6頁，共19頁。Stroke rehabilitation approachesAll approaches involve the process of re-learningEg:Neurodevelopmental treatment (Bobath)Motor re-learning (Carr & Shepherd) Task- oriented approachesCompensatory第

6、7頁，共19頁。Mental practice theoriesIt is debated whether mental practice relies on motor, cognitive or motivational processesMental practice is more effective when learning simple tasksImagery abilities may vary Tasks learned must be meaningful & prior experience of the activity is necessary第8頁，共19頁。Ho

7、w mental imagery can promote functional independence through relearning第9頁，共19頁。Mental practice used in occupational therapyPage, Levine & Leonard (2005) Investigated the efficacy of mental practice in increasing the function & use of the affected upper limb of 11 stroke patients. Randomized, contro

8、lled pre-post case series study Tasks were reaching & grasping a cup, turning pages & using a pen.第10頁，共19頁。Mental practice used in occupational therapyPage, Levine & Leonard (2005) Results showed:Increased affected limb use and functionSkills had been generalized to other ADLs after intervention第11

9、頁，共19頁。Mental practice used in occupational therapySmania, et al. (1997) Studied the effectiveness of visuomotor imagery practice in rehabilitation of unilateral neglectBefore / after trial on 2 participantsMental imagery included imagining patients at home, geographical areas, reverse spelling & me

10、ntal representation.第12頁，共19頁。Mental practice used in occupational therapySmania, et al. (1997) Outcomes assessed using functional tests & neuropsychological testsVisuomotor imagery training found to improve performance deficits related to neglect第13頁，共19頁。Mental practice used in occupational therap

11、yLiu et al., (2004) Studied the efficacy of mental imagery at promoting relearning for people after a strokeProspective, randomized controlled trial, of 46 stroke inpatients aged over 60 years. MP Protocol used picture cards, visualizing performance and watching videotaped performance第14頁，共19頁。Menta

12、l practice used in occupational therapyLiu et al., (2004) Outcome measures used were the performance of 15 trained and 5 untrained daily living tasksPatients who engaged in mental practice improved their attention & sequencing abilityIncreased their relearning of familiar and new tasks第15頁，共19頁。Bene

13、fits of using mental practiceIncreases affected limb use and functionCan improve cognitive skills (eg attention, sequencing) Creates opportunities for clients to problem-solveUses a client-centred approach Time / cost -effective 第16頁，共19頁。Areas for further researchEstablishing guidelines and protoco

14、lsMotivational aspects of relearning through mental practiceLong-term occupational benefits第17頁，共19頁。Sarah Freemansarahsarahfreeman.co.ukMental Practice第18頁，共19頁。ReferencesBell, A. & Murray, B (2004) Improvement in Upper Limb Motor Performance following Stroke: the Use of Mental Practice. British Jo

15、urnal of Occupational Therapy 67 (11): 501-507.Kosslyn,S.M. (1994) Image and brain : the resolution of the imagery debate. Cambridge, Mass. ; London : MIT PressLiu, K. P., Chan, C. C., Lee, T., Hui-Chan, C. W. (2004) Mental Imagery for Promoting Relearning for People After Stroke: A Randomized Contr

16、olled Trial. Archives of Physical Medical Rehabilitation 85:1403-8.Page, S. Levine, P. Leonard, A. (2005) Effects of Mental Practice on Affected Limb Use and Function in Chronic Stroke. Archives of Physical & Medical Rehabilitation 86 399-402.Richardson, A (1967) Mental Practice: a review and discussion (part 1). Research Quarterly (38): 95-107Smania, N., Bazoli, .F, Piva, D., Guidetti, G. (19