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Motor Imagery / Mental Practice

Introduction

What is Motor Imagery?
Motor imagery (MI) involves activation of the neural system while a person imagines performing a task or body movement without actually physically performing the movement. MI has been used after a stroke to attempt to treat loss of arm, hand and lower extremity movement, to help improve performance in activities of daily living, to help improve gait, and to minimize the effects of unilateral spatial neglect. Motor imagery can be used in the acute phase, sub-acute phase or chronic phase of rehabilitation.

It has been shown that while motor imagery is beneficial by itself, it is most effective when used in addition to physical practice. In fact, many of the first studies on MI were designed to investigate whether MI improved motor performance in athletes.

Brain scanning techniques have shown that similar areas of the brain are activated during MI and physical movement. In addition, MI has been shown in one study to help the brain reorganize its neural pathways, which may help promote learning of motor tasks after a stroke.

NOTE: It is to be noted that this intervention is still in the early stages of scientific investigation for treatment post-stroke and as such there are few RCTs available to guide decisions regarding the effectiveness of this treatment.


Authors*: Angela Kim, B.Sc., Adam Kagan, B.Sc.; Emilie Belley B.A. Psychology, B.Sc PT; Mathilde Parent-Vachon Bsc PT; Josee-Anne Filion; Alison Nutter; Marie Saulnier; Stephanie Shedleur, Bsc PT; Tsz Ting Wan, BSc PT; Elissa Sitcoff, BA BSc; Nicol Korner-Bitensky, PhD OT


Expert Reviewer: Stephen Page, PhD (C)

NOTE: *The authors have no direct financial interest in any tools, tests or interventions presented in StrokEngine.

 

1a (Strong) Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings
1b(Moderate) 1 RCT of high quality (PEDro ≥ 6)
2a (Limited) At least 1 fair quality RCT (PEDro = 4-5)
2b (Limited) At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.)
3(Consensus) Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results
4 (Conflicting) Conflicting evidence of 2 or more equally well-designed studies
5 (No evidence) No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines)

Patients between 1-6 months post-stroke are identified as in sub-acute stage of recovery.

 

*high quality = PEDro score 6-10

*fair quality = PEDro score 4-5

*poor quality = PEDro score ≤ 3

The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/

A randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness.

 

1a (Strong) Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings
1b(Moderate) 1 RCT of high quality (PEDro ≥ 6)
2a (Limited) At least 1 fair quality RCT (PEDro = 4-5)
2b (Limited) At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.)
3(Consensus) Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results
4 (Conflicting) Conflicting evidence of 2 or more equally well-designed studies
5 (No evidence) No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines)

Patients between 1-6 months post-stroke are identified as in sub-acute stage of recovery.

Patients longer than 6 months post-stroke are identified as in chronic stage of recovery.

 

1a (Strong) Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings
1b(Moderate) 1 RCT of high quality (PEDro ≥ 6)
2a (Limited) At least 1 fair quality RCT (PEDro = 4-5)
2b (Limited) At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.)
3(Consensus) Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results
4 (Conflicting) Conflicting evidence of 2 or more equally well-designed studies
5 (No evidence) No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines)

 

1a (Strong) Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings
1b(Moderate) 1 RCT of high quality (PEDro ≥ 6)
2a (Limited) At least 1 fair quality RCT (PEDro = 4-5)
2b (Limited) At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.)
3(Consensus) Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results
4 (Conflicting) Conflicting evidence of 2 or more equally well-designed studies
5 (No evidence) No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines)

 

Patients between 1-6 months post-stroke are identified as in sub-acute stage of recovery.

Patients longer than 6 months post-stroke are identified as in chronic stage of recovery.

1a (Strong) Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings
1b(Moderate) 1 RCT of high quality (PEDro ≥ 6)
2a (Limited) At least 1 fair quality RCT (PEDro = 4-5)
2b (Limited) At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.)
3(Consensus) Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results
4 (Conflicting) Conflicting evidence of 2 or more equally well-designed studies
5 (No evidence) No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines)

1a (Strong) Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings
1b(Moderate) 1 RCT of high quality (PEDro ≥ 6)
2a (Limited) At least 1 fair quality RCT (PEDro = 4-5)
2b (Limited) At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.)
3(Consensus) Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results
4 (Conflicting) Conflicting evidence of 2 or more equally well-designed studies
5 (No evidence) No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines)

Patients between 1-6 months post-stroke are identified as in sub-acute stage of recovery.

Patients longer than 6 months post-stroke are identified as in chronic stage of recovery.

 

*high quality = PEDro score 6-10

*fair quality = PEDro score 4-5

*poor quality = PEDro score ≤ 3

The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/

A randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness.

 

1a (Strong) Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings
1b(Moderate) 1 RCT of high quality (PEDro ≥ 6)
2a (Limited) At least 1 fair quality RCT (PEDro = 4-5)
2b (Limited) At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.)
3(Consensus) Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results
4 (Conflicting) Conflicting evidence of 2 or more equally well-designed studies
5 (No evidence) No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines)

Patients less than a month post-stroke are identified as in acute stage of recovery.

1a (Strong) Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings
1b(Moderate) 1 RCT of high quality (PEDro ≥ 6)
2a (Limited) At least 1 fair quality RCT (PEDro = 4-5)
2b (Limited) At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.)
3(Consensus) Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results
4 (Conflicting) Conflicting evidence of 2 or more equally well-designed studies
5 (No evidence) No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines)

A randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness.

Patients between 1-6 months post-stroke are identified as in sub-acute stage of recovery.

Patients longer than 6 months post-stroke are identified as in chronic stage of recovery.

1a (Strong) Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings
1b(Moderate) 1 RCT of high quality (PEDro ≥ 6)
2a (Limited) At least 1 fair quality RCT (PEDro = 4-5)
2b (Limited) At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.)
3(Consensus) Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results
4 (Conflicting) Conflicting evidence of 2 or more equally well-designed studies
5 (No evidence) No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines)

*high quality = PEDro score 6-10

*fair quality = PEDro score 4-5

*poor quality = PEDro score ≤ 3

The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/

A randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness.

A randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness.

A randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness.

A randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness.

A randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness.

A randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness.

A randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness.

Patients between 1-6 months post-stroke are identified as in sub-acute stage of recovery.

*high quality = PEDro score 6-10

*fair quality = PEDro score 4-5

*poor quality = PEDro score ≤ 3

The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/

1a (Strong) Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings
1b(Moderate) 1 RCT of high quality (PEDro ≥ 6)
2a (Limited) At least 1 fair quality RCT (PEDro = 4-5)
2b (Limited) At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.)
3(Consensus) Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results
4 (Conflicting) Conflicting evidence of 2 or more equally well-designed studies
5 (No evidence) No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines)

1a (Strong) Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings
1b(Moderate) 1 RCT of high quality (PEDro ≥ 6)
2a (Limited) At least 1 fair quality RCT (PEDro = 4-5)
2b (Limited) At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.)
3(Consensus) Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results
4 (Conflicting) Conflicting evidence of 2 or more equally well-designed studies
5 (No evidence) No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines)

*high quality = PEDro score 6-10

*fair quality = PEDro score 4-5

*poor quality = PEDro score ≤ 3

The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/

1a (Strong) Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings
1b(Moderate) 1 RCT of high quality (PEDro ≥ 6)
2a (Limited) At least 1 fair quality RCT (PEDro = 4-5)
2b (Limited) At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.)
3(Consensus) Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results
4 (Conflicting) Conflicting evidence of 2 or more equally well-designed studies
5 (No evidence) No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines)

*high quality = PEDro score 6-10

*fair quality = PEDro score 4-5

*poor quality = PEDro score ≤ 3

The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/

*high quality = PEDro score 6-10

*fair quality = PEDro score 4-5

*poor quality = PEDro score ≤ 3

The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/

 

*high quality = PEDro score 6-10

*fair quality = PEDro score 4-5

*poor quality = PEDro score ≤ 3

The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/

1a (Strong) Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings
1b(Moderate) 1 RCT of high quality (PEDro ≥ 6)
2a (Limited) At least 1 fair quality RCT (PEDro = 4-5)
2b (Limited) At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.)
3(Consensus) Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results
4 (Conflicting) Conflicting evidence of 2 or more equally well-designed studies
5 (No evidence) No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines)

1a (Strong) Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings
1b(Moderate) 1 RCT of high quality (PEDro ≥ 6)
2a (Limited) At least 1 fair quality RCT (PEDro = 4-5)
2b (Limited) At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.)
3(Consensus) Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results
4 (Conflicting) Conflicting evidence of 2 or more equally well-designed studies
5 (No evidence) No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines)

1a (Strong) Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings
1b(Moderate) 1 RCT of high quality (PEDro ≥ 6)
2a (Limited) At least 1 fair quality RCT (PEDro = 4-5)
2b (Limited) At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.)
3(Consensus) Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results
4 (Conflicting) Conflicting evidence of 2 or more equally well-designed studies
5 (No evidence) No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines)

1a (Strong) Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings
1b(Moderate) 1 RCT of high quality (PEDro ≥ 6)
2a (Limited) At least 1 fair quality RCT (PEDro = 4-5)
2b (Limited) At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.)
3(Consensus) Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results
4 (Conflicting) Conflicting evidence of 2 or more equally well-designed studies
5 (No evidence) No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines)

1a (Strong) Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings
1b(Moderate) 1 RCT of high quality (PEDro ≥ 6)
2a (Limited) At least 1 fair quality RCT (PEDro = 4-5)
2b (Limited) At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.)
3(Consensus) Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results
4 (Conflicting) Conflicting evidence of 2 or more equally well-designed studies
5 (No evidence) No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines)

Patients between 1-6 months post-stroke are identified as in sub-acute stage of recovery.

Patients longer than 6 months post-stroke are identified as in chronic stage of recovery.

Patients less than a month post-stroke are identified as in acute stage of recovery.

*high quality = PEDro score 6-10

*fair quality = PEDro score 4-5

*poor quality = PEDro score ≤ 3

The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/

A randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness.

1a (Strong) Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings
1b(Moderate) 1 RCT of high quality (PEDro ≥ 6)
2a (Limited) At least 1 fair quality RCT (PEDro = 4-5)
2b (Limited) At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.)
3(Consensus) Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results
4 (Conflicting) Conflicting evidence of 2 or more equally well-designed studies
5 (No evidence) No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines)

A randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness.

*high quality = PEDro score 6-10

*fair quality = PEDro score 4-5

*poor quality = PEDro score ≤ 3

The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/

Patients less than a month post-stroke are identified as in acute stage of recovery.

*high quality = PEDro score 6-10

*fair quality = PEDro score 4-5

*poor quality = PEDro score ≤ 3

The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/

*high quality = PEDro score 6-10

*fair quality = PEDro score 4-5

*poor quality = PEDro score ≤ 3

The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/

*high quality = PEDro score 6-10

*fair quality = PEDro score 4-5

*poor quality = PEDro score ≤ 3

The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/

*high quality = PEDro score 6-10

*fair quality = PEDro score 4-5

*poor quality = PEDro score ≤ 3

The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/

*high quality = PEDro score 6-10

*fair quality = PEDro score 4-5

*poor quality = PEDro score ≤ 3

The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/

A randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness.

Patients between 1-6 months post-stroke are identified as in sub-acute stage of recovery.

Patients longer than 6 months post-stroke are identified as in chronic stage of recovery.

*high quality = PEDro score 6-10

*fair quality = PEDro score 4-5

*poor quality = PEDro score ≤ 3

The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/

A randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness.

Patients longer than 6 months post-stroke are identified as in chronic stage of recovery.