Effects of Motor Imagery on Hand Function During Immobilization After Flexor Tendon Repair

Stenekes MW, Geertzen JH, Nicolai J-P, De Jong BM, Mulder T. Effects of motor imagery on hand function during immobilization after flexor tendon repair. Arch Phys Med Rehabil 2009;90:553-9. Objective: To determine whether motor imagery during the immobilization period after flexor tendon injury results in a faster recovery of central mechanisms of hand function. Design: Randomized controlled trial. Setting: Tertiary referral hospital. Participants: Patients (N=28) after surgical flexor tendon repair were assigned to either an intervention group or a control group. Intervention: Kinesthetic motor imagery of finger flexion movements during the postoperative dynamic splinting period. Main Outcome Measures: The central aspects of hand function were measured with a preparation time test of finger flexion in which subjects pressed buttons as fast as possible following a visual stimulus. Additionally, the following hand function modalities were recorded: Michigan Hand Questionnaire, visual analog scale for hand function, kinematic analysis of drawing, active total motion, and strength. Results: After the immobilization period, the motor imagery group demonstrated significantly less increase of preparation time than the control group (P=.024). There was no significant influence of motor imagery on the other tested hand function (P>.05). All tests except kinematic analysis (P=.570) showed a significant improvement across time after the splinting period (P <=.00 1). Conclusions: Motor imagery significantly improves central aspects of hand function, namely movement preparation time, while other modalities of hand function appear to be unaffected.