Recovery of motor imagery ability in the first year after stroke.

The aim of this study was to examine the level and recovery of motor imagery ability (MIA) in the first year after stroke and whether the recovery of MIA is related to that of arm/hand function. Twenty-three patients with diminished arm/hand function were included. The accuracy score on the hand laterality judgment task was used to assess MIA and the Fugl-Meyer Assessment was used to evaluate the recovery of arm/hand function. The patients were assessed 3, 6, 16, 26, and 52 weeks after stroke. In the first year after stroke, the percentage of patients with moderate to good MIA improved from 78% after 3 weeks to 94% after 1 year. The recovery of MIA took place in the first 6 weeks after stroke. No correlation was found between the recovery of MIA and arm/hand function, despite the fact that the greatest improvement in both occurred in the first 6 weeks.

Using the Hand Laterality Judgement Task to assess motor imagery: a study of practice effects in repeated measurements.

The aim of this study was to determine whether there is a practice effect on the Hand Laterality Judgement Task (HLJT). The HLJT task is a mental rotation task that can be used to assess motor imagery ability in stroke patients. Thirty-three healthy individuals performed the HLJT and two control tasks twice at a 3-week interval. Differences in the accuracy and the response times were analysed. The results for all three tasks showed a decrease in the response time between the first and the second assessments (8-20%), and, for the HLJT, also a small (3%) but relevant increase in accuracy. The most likely factor explaining this improvement is that of practice effects. This implies that an improvement in the HLJT scores found over time in clinical research may be partly because of a learning effect, which has to be taken into account when interpreting the results. It is likely that a practice effect occurs in repeated measurements of the HLJT.

Goal setting in Dutch paediatric rehabilitation. Are the needs and principal problems of children with cerebral palsy integrated into their rehabilitation goals?

OBJECTIVE: To evaluate whether the needs and principal problems of children with cerebral palsy (CP) as formulated in their interdisciplinary rehabilitation reports are integrated into the goal descriptions and whether this depends on the nature of the needs and problems. DESIGN: Descriptive multiple-case study. SETTING: Five Dutch paediatric rehabilitation facilities. SUBJECTS: The rehabilitation profiles of 41 children with cerebral palsy aged between 4 and 8 years. METHODS: The raw text data were extracted and organized, after which two raters independently linked the extracted content to the categories of the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY). Matches between needs, problems and goals were identified by ICF-CY code comparisons. RESULTS: The Cohen's kappas for ICF-CY encoding were all in the range of "fair to good" (0.52-0.78). For five children (12%) no needs had been formulated and the reports of 10 (24%) were excluded from further analyses as they lacked a principal goal. In the 31 reports analysed, 29 (23%) need constructs and 46 (46%) problem constructs were incorporated into the goals. Of the total of 95 goal constructs 49 (52%) were not related to either a need or a problem construct. No clear relationship could be established between the type of needs and problems and their inclusion or exclusion in the principal goals. CONCLUSION: Overall, the integration of the needs and principal problems of children with their rehabilitation goals was not optimal. However, integration was difficult to objectify because needs, problems and goals were poorly documented.