The efficacy of combined physical and mental practice in the learning of a foot-sequence task after stroke: a case report

Neurorehabil Neural Repair. 2004 Jun;18(2):106-11. doi: 10.1177/0888439004265249.


Objective: To investigate the effect of mental practice on the learning of a sequential task for the lower limb in a patient with a hemiparesis resulting from a stroke.

Design: A single-case study.

Setting: Research laboratory of a university-affiliated rehabilitation center.

Patient: A right-handed 38-year-old man who had suffered a left hemorrhagic subcortical stroke 4 months prior.

Intervention: The patient practiced a serial response time task with the lower limb in 3 distinct training phases over a period of 5 weeks: 2 weeks of physical practice, 1 week of combined physical and mental practice, and then 2 weeks of mental practice alone.

Main outcome measures: Performance on the task measured through errors and response times. Imagery abilities measured through questionnaires.

Results: The patient's average response time improved significantly during the 1st 5 days of physical practice (26%) but then failed to show further improvement during the following week of physical practice. The combination of mental and physical practice during the 3rd week yielded additional improvement (10.3%), whereas the following 2 weeks of mental practice resulted in a marginal increase in performance (2.2%).

Conclusion: The findings show that mental practice, when combined with physical practice, can improve the performance of a sequential motor skill in people who had a stroke, and suggest that mental practice could play a role in the retention of newly acquired abilities.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Foot / physiopathology*
  • Humans
  • Imagery, Psychotherapy*
  • Male
  • Motor Activity*
  • Paresis / etiology
  • Paresis / rehabilitation*
  • Practice, Psychological*
  • Stroke / complications*
  • Task Performance and Analysis
  • Treatment Outcome