Alhashil N1,2, Fletcher-Smith J1, Kontou E1, Radford K1
1University of Nottingham, Division of Rehabilitation and Ageing, School of Medicine, Nottingham, United Kingdom, 2King Fahd University Hospital, University of Imam Abdulrhman Bin Faisal, Physiotherapy Department, Al Khobar, Saudi Arabia
Background: Rehabilitation is important for promoting post-stroke recovery. One potentially cost-effective method is the use of mental imagery (MI). Mental imagery is defined as the experience of generating images of movements in the mind using different senses, such as visualising oneself exercising or feeling oneself performing an exercise. Reported findings from randomized clinical trials have suggested that the practice of MI improves functional stroke recovery; however, guidelines for its use in Saudi Arabian clinical practice are not yet available.
Purpose: The purpose of this study was to explore the current use of MI in stroke rehabilitation and identify barriers and enablers to clinical implementation by therapists in Saudi Arabia.
Methods: Focus groups and interviews were conducted with healthcare professionals and stroke survivors selected from three healthcare facilities in Saudi Arabia. Data were analysed thematically using Framework by NA and themes agreed by the research team.
Results: Twenty-three participants, including physiotherapists (n=18) and occupational therapists (n=5) and twelve stroke survivors, were interviewed. Three themes emerged from the professionals; 'Therapists' Views', 'Patient engagement in MI use' and 'Examples of MI delivery'. Five themes were identified from stroke survivors. These were 'Sources of information', 'enablers', 'barriers', 'patients' expectations' and 'patients' experiences in MI use'.
Conclusion(s): MI was a novel intervention not currently used by any of the therapists interviewed. They believed that theoretical knowledge and practical experience were essential for delivering MI successfully in stroke rehabilitation and that professional training courses and workshops were needed. They identified patient attributes important for effective patient engagement and were anxious about its acceptability to stroke survivors more familiar with passive rehabilitation techniques. Most stroke survivors had heard or experienced MI and were motivated to use it in rehabilitation and optimistic about its effects. However, they highlighted the importance of the therapist's role in training and supporting them to use MI effectively and in suggesting potential benefits of use.
Implications: The study has offered insight into therapists' and stroke survivors' experiences and perceptions concerning the use of MI in clinical practice in Saudi Arabia. Findings suggest the need for best practice clinical guidelines to be developed and protocols for training stroke survivors in MI use and training for therapists to deliver mental imagery effectivelyin clinical practice.
Keywords: Stroke, Mental imagery, Rehabilitation
Funding acknowledgements: This research is supported through a PhD scholarship from Imam Abdulrahman Bin Faisal
University, Saudi Arabia.
Purpose: The purpose of this study was to explore the current use of MI in stroke rehabilitation and identify barriers and enablers to clinical implementation by therapists in Saudi Arabia.
Methods: Focus groups and interviews were conducted with healthcare professionals and stroke survivors selected from three healthcare facilities in Saudi Arabia. Data were analysed thematically using Framework by NA and themes agreed by the research team.
Results: Twenty-three participants, including physiotherapists (n=18) and occupational therapists (n=5) and twelve stroke survivors, were interviewed. Three themes emerged from the professionals; 'Therapists' Views', 'Patient engagement in MI use' and 'Examples of MI delivery'. Five themes were identified from stroke survivors. These were 'Sources of information', 'enablers', 'barriers', 'patients' expectations' and 'patients' experiences in MI use'.
Conclusion(s): MI was a novel intervention not currently used by any of the therapists interviewed. They believed that theoretical knowledge and practical experience were essential for delivering MI successfully in stroke rehabilitation and that professional training courses and workshops were needed. They identified patient attributes important for effective patient engagement and were anxious about its acceptability to stroke survivors more familiar with passive rehabilitation techniques. Most stroke survivors had heard or experienced MI and were motivated to use it in rehabilitation and optimistic about its effects. However, they highlighted the importance of the therapist's role in training and supporting them to use MI effectively and in suggesting potential benefits of use.
Implications: The study has offered insight into therapists' and stroke survivors' experiences and perceptions concerning the use of MI in clinical practice in Saudi Arabia. Findings suggest the need for best practice clinical guidelines to be developed and protocols for training stroke survivors in MI use and training for therapists to deliver mental imagery effectivelyin clinical practice.
Keywords: Stroke, Mental imagery, Rehabilitation
Funding acknowledgements: This research is supported through a PhD scholarship from Imam Abdulrahman Bin Faisal
University, Saudi Arabia.
Topic: Neurology: stroke
Ethics approval required: Yes
Institution: The Nottingham Research Ethics Committee (IRB 44-1704)
Ethics committee: The University Imam Abdulrhman Faisal Research Ethics Committee (IRB 2017-11-096)
Ethics number: King Fahd Hospital Research Ethics Committee (IRB–EXT0338)
All authors, affiliations and abstracts have been published as submitted.
