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Motor Imagery for Gait Rehabilitation in Post-Stroke Hemiparesis

R Dickstein, PT, DSc, is Associate Professor, Department of Physical Therapy, Faculty of Social Welfare and Health Studies, The University of Haifa, Mount Carmel, Haifa 31905, Israel (ruthd{at}research.haifa.ac.il), and Flieman Geriatric Rehabilitation Center, Haifa POB 2263, Israel
A Dunsky, MS, is a doctoral student, Graduate Studies Authority, The University of Haifa
E Markovitz, MD, is Specialist in Physical Medicine and Rehabilitation, Flieman Geriatric Rehabilitation Center

Address all correspondence to Dr Dickstein at the University of Haifa

Background and Purpose. Reports have described the contribution of motor imagery (MI) practice for improving upper-extremity functions in patients with hemiparesis following stroke. The purpose of this case report is to describe the use of MI practice to attempt to improve walking in an individual with hemiparesis. Case Description. A 69-year-old man with left hemiparesis received MI gait practice for 6 weeks. Intervention focused on task-oriented gait and on impairments of the affected lower limb. Preintervention, midterm, postintervention, and follow-up measurements of temporal-distance stride parameters and sagittal kinematics of the knee joint were taken. Main Outcomes. At 6 weeks postintervention, the patient had a 23% increase in gait speed and a 13% reduction in double-support time. An increase in range of motion of the knees also was observed. No changes in gait symmetry were noted. Discussion. The outcomes suggest that MI may be useful for the enhancement of walking ability in patients following stroke. Because improvement was mainly in temporal-distance gait variables and knee movement, imagery practice probably should focus on its specific impairments during gait in order to affect the performance of the paretic lower extremity.

Key Words: Gait • Hemiparesis • Mental practice • Motor imagery • Stroke

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