Influence of functional task-oriented mental practice on the gait of transtibial amputees: a randomized, clinical trial.
Rodrigo Gontijo Cunha, Paulo José Guimarães Da-Silva, Clarissa Cardoso Dos Santos Couto Paz and 2 others
PMID 28399873WHAT IT FOUND
Amputees who imagined walking tasks and also received gait training showed a lower heel-contact force peak and longer prosthetic support after intervention.
The non-motor mental practice group did not change. Mental practice alone was not tested.
Key findings
01In Group A, the first vertical force peak on the prosthetic limb decreased from 89.6% of body weight before intervention to 77.2% after intervention, with p = 0.002.
02In Group A, the support phase of the prosthetic limb increased from 0.434 s before intervention to 0.640 s after intervention, with p = 0.002, and remained 0.647 s at follow-up.
03Group A received gait training after mental practice, while Group B did not, so the trial does not isolate mental practice alone.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The sample was very small: 10 volunteers in the gait-oriented group and 5 in the control group after reassignment and dropout. Only male volunteers were included, so the results may not apply to female amputees. The groups were not kept separate as originally planned; three control volunteers were moved to the intervention group after a preliminary analysis. The intervention group received gait training after mental practice, while the control group did not, so mental practice alone was not tested. The paper does not report blinding of participants, therapists, or outcome assessors. Gait was measured only on the prosthetic limb, not the intact limb, so double support, step length, and overall symmetry were not assessed. The study did not include a comparison group that received gait training alone. Follow-up was 1 month.
The easy way to misread this
Do not conclude that mental practice by itself improves gait. Group A also received gait training after mental practice, and Group B did not receive that training, so the added effect of mental practice alone cannot be separated.