UC to Study Whether Mental "Rehearsal" Can Help Stroke Patients Function Again

Two new studies led by a UC researcher will examine how mental “rehearsal” of physical activities can improve motor skills in stroke patients.

The studies, led by Stephen Page, PhD, director of research and assistant professor in the Department of Physical Medicine and Rehabilitation, are funded by nearly $1 million from the National Institutes of Health and will be conducted at the Drake Center.

“Following stroke, patients often have to undergo difficult physical therapy programs to regain the ability to perform everyday functions,” says Dr. Page. “The problem is that stroke patients are often unable or unwilling to practice these exercises at home.”

Research has shown that mental practice, or thinking about performing physical movements, activates the same muscles in the body as actual practice of the same task. Using neuroimaging, studies have shown that the same areas of the brain that become active through a certain physical activity can also become active through mental practice of that same activity.

“If we can give patients exercises that are easily altered for home practice, they will be much more likely to continue therapy on their own and have success,” says Dr. Page. “Because mental practice can produce such powerful reactions in the body and the brain, we think stroke patients can benefit substantially from this exercise.”

UC will conduct a two-year study with chronic stroke patients—those whose stroke occurred more than one year ago, and a five-year study on subacute stroke patients—patients who are three months to a year post stroke.

These new studies build on Dr. Page's previous work, which has shown that mental practice of motor skills substantially improves stroke patients’ motor function levels.

The studies will couple physical therapy with mental practice. The goal, says Dr. Page, is to determine how much mental practice should be combined with physical therapy for the most benefit.

In addition to looking at improved physical function, Dr. Page will use functional magnetic resonance imaging (fMRI) to determine how brain activity is affected, and whether fMRI could be used to determine the relative “dosages” of mental and physical practice.

“We believe there’s greater potential for the brain to adapt to injury in the subacute patients,” says Dr. Page. “This study with those patients will be the first randomized controlled study to examine this theory in detail, and the first to apply fMRI to examine how mental practice affects brain function in this group.”

According to the American Stroke Association, about 700,000 Americans will have a stroke in 2005. Stroke is the nation’s No. 3 killer and the leading cause of severe, long-term disability. In 1999,

1.1 million American adults who had suffered a stroke reported functional limitations and difficulties performing day-to-day tasks.

Dr. Page is also a member of UC’s Institute for the Study of Health and the Greater Cincinnati/Northern Kentucky Stroke Team.

Both studies are now enrolling participants. For more information, contact Dr. Page at 513-558-2754 or e-mail

stephen.page@uc.edu

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