Motor Imagery Training for Gait Rehabilitation of People With Post-Stroke Hemiparesis: Practical Applications and Protocols

Over the last two decades, the use of motor imagery (MI) for post-stroke rehabilitation has significantly increased. Previous findings support the feasibility of the incorporation of specific MI exercises to improve walking skills in individuals with post-stroke hemiparesis. However, detailed practical applications and specific protocols for the implementation of MI are scarce. The objective of this manuscript is to propose practical applications for a structured MI regimen, including detailed protocols of a six-week intervention targeting gait improvement following stroke. The proposed regimen is based on previous experience with MI rehabilitation programs for gait improvement following stroke, motor learning principles with applications for stroke rehabilitation, and the PETTLEP model. The proposed detailed protocols were found to be adjusted for gait improvement of post-stroke survivors as described in several studies, and may address the targets of different rehabilitation programs. Based on motor learning principles and guidelines, an example of verbal instructions for each treatment session during six weeks of intervention is proposed. The potential of this training program to augment and extend the rehabilitation process was proven in several studies. The variety of possibilities of scenes to image allows the clinician to target specific impaired performance and disabilities. By using the proposed structure and protocols, a large number of therapists may be able to address these targets.