MP combined with occupational therapy improves upper-extremity recovery after stroke. MP does not appear to enhance self-perception of performance. This preliminary study suggests that imagery perspective may not be an important variable in MP interventions.

OBJECTIVE. We sought to determine whether mental practice is an effective intervention to improve upper-limb recovery after stroke. METHOD. We conducted a systematic review of the literature, searching electronic databases for the years 1985 to February 2009. We selected studies according to specified criteria, rated each study for level of evidence, and summarized study elements. RESULTS. Studies differed with respect to design, patient characteristics, intervention protocols, and outcome measures. All studies used imagery of tasks involving movement of the impaired limb. The length of the interventions and number of practice hours varied. Results suggest that mental practice combined with physical practice improves upper-limb recovery. CONCLUSION. When added to physical practice, mental practice is an effective intervention. However, generalizations are difficult to make. Further research is warranted to determine who will benefit from training, the dosing needed, the most effective protocols, whether improvements are retained, and whether mental practice affects perceived occupational performance.

Using 120-fs, 800-nm Ti:sapphire laser pulses, ionic yields of singly and doubly charged magnesium ions were measured as a function of intensity and laser field ellipticity. A clear ''nonsequential'' enhancement of the doubly charged ion is observed for circularly polarized light in addition to linearly polarized light. Over the entire intensity range the double-ionization yield is considerably higher for linear polarization than it is for circular polarization.

Objective This study was designed to examine the feasibility of immersive virtual reality mirror therapy for upper limb paresis after stroke using a head-mounted display and provide preliminary evidence of efficacy. Design Ten outpatients with chronic stroke, upper limb hemiparesis, and a low predisposition for motion sickness completed a 12-session program of 30 mins each of immersive virtual reality mirror therapy. The virtual reality system provided the illusion of movement in the hemiparetic upper limb while suppressing the visual representation of the nonparetic side. Feasibility was assessed via patient compliance, adverse event tracking, the System Usability Scale, and the Simulator Sickness Questionnaire. Preliminary efficacy was evaluated using the Fugl-Meyer Upper Extremity and Action Research Arm Test. Results Immersive virtual reality mirror therapy for patients with chronic stroke was safe, well-tolerated, and without adverse events, such as simulator sickness. Motor outcomes revealed a small improvement for the Fugl-Meyer Upper Extremity from 21.7 (SD = 8.68) to 22.8 (SD = 9.19) that did not achieve statistical significance (P = 0.084). Conclusions Four weeks of immersive virtual reality mirror therapy was well-tolerated by chronic stroke patients. Our findings support further clinical trials of immersive virtual reality technologies and visually enhanced mirror therapies for stroke survivors.