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Purpose: Although several types of occupational therapy for motor recovery of the upper limb in patients with chronic stroke have been investigated, most treatments are performed in a hospital or clinic setting. We investigated the effect of graded motor imagery (GMI) training, as a home exercise program, on upper limb motor recovery and activities of daily living (ADL) in patients with stroke., Methods: This prospective randomized controlled trial recruited 42 subjects with chronic stroke. The intervention group received instruction regarding the GMI program and performed it at home over 8 weeks (30 minutes a day). The primary outcome measure was the change in motor function between baseline and 8 weeks, assessed the Manual Function Test (MFT) and Fugl-Meyer Assessment (FMA). The secondary outcome measure was the change in ADL, assessed with the Modified Barthel Index (MBI)., Results: Of the 42 subjects, 37 completed the 8-week program (17 in the GMI group and 20 controls). All subjects showed significant improvements in the MFT, FMA, and MBI over time (P < .05). However, the improvements in the total scores for the MFT, FMA, and MBI did not differ between the GMI and control groups. The MFT arm motion score for the GMI group was significantly better than that of the controls (P < .05)., Conclusions: The GMI program may be useful for improving upper extremity function as an adjunct to conventional rehabilitation for patients with chronic stroke., Competing Interests: The authors have no conflicts of interests to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)

Elderly patients undergoing surgery often suffer from sleep disorder. Holistic therapies might help them sleep better. The aim of this research was to determine the effect of guided imagery along with breathing relaxation on sleep quality in elderly patients undergoing abdominal surgery. A double-blind randomized clinical trial was conducted on 90 elderly patients undergoing abdominal surgery in 2 educational hospitals in 2018, Mashhad, Iran. The elderly patients with different abdominal surgical procedures were distributed to the wardrooms and then the rooms were randomly assigned into 2 groups. In the intervention group, the patients learned breathing relaxation the day before surgery and then an audiotape was provided to perform the guided imagery from the day before surgery for 5 days (twice) along with breathing relaxation. St Mary's Hospital Sleep Inventory was completed the night before, 48 hours and 96 hours after the surgery. Data analysis was done using SPSS 21 through analytical tests. Results of the test indicated that the score of sleep quality was significantly higher in the intervention group the night before surgery (P = .001). The total scores of sleep quality in the intervention group 48 and 96 hours after the surgery were significantly higher (P < .001). Based on results of generalized estimating equation model, the score of sleep quality for patients was 8.76 units higher in the intervention group than in the control group by controlling for the effects of time. Guided imagery along with breathing relaxation improved the sleep quality of the elderly patients undergoing abdominal surgery.Trial registration: IRCT20180731040652N1.

Objective: Adult research employing script-driven imagery procedures has shown the method to be a valuable tool for studying the nature, correlates, and consequences of trauma and posttraumatic stress symptoms (PTSS). The purpose of the current study was to examine the validity of a trauma-focused script-driven imagery procedure among youth., Method: Responding to script-driven imagery was examined in relation to PTSS among 60 traumatic event-exposed adolescents, ages 10 to 17 years., Results: In support of concurrent validity, PTSS was associated with self-reported anxiety, fear, disgust, and distress responses to the script. Script-elicited reexperiencing, dissociation, and total state-symptoms were associated with interview-measured severity of PTSS. However, neither script-elicited avoidance symptoms nor physiological reactivity to the script were related to PTSS. In support of discriminant validity, adolescents' self-reported thought problems were not related to script-elicited affective, physiological, or state-symptom outcomes., Conclusion: Research is needed to understand why certain variables, such as physiological reactivity to the script, did not relate to PTSS. However, results suggest the traumatic event-focused script driven imagery procedure is a useful method for activating a trauma-related emotion network and measuring psychological reactivity to reminders of traumatic event cues among adolescents. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Purpose: To contribute to the treatment fidelity literature by providing real-world examples and suggestion for future research and potential clinical application, this article reports on implementation, assessment, and evaluation of treatment fidelity in mind-body self-care approaches in at-risk women., Method: Aligning with best practices, treatment fidelity was integrated into three randomized clinical trials. The first examined the effects of a tai chi intervention designed to decrease cardiometabolic risk factors in women; the second examined the effects of a tailored guided imagery intervention on pregnancy outcomes in African American women; and the third explored effects of a mindful physical activity intervention (yoga) on psychological outcomes in women with moderate to severe depressive symptoms., Findings: Each of the studies successfully designed, implemented, and evaluated strategies to address recommended treatment fidelity components. These strategies provided qualitative and quantitative data that informed intervention refinement, directions for future research, and application in clinical practice., Conclusions: The treatment fidelity framework used here is based on best practices and was a feasible and reliable approach for ensuring and reporting on treatment fidelity, which is contributing to future research to foster translation of potentially effective mind-body self-care approaches into practice.

Motor imagery has emerged as a potential rehabilitation tool in stroke. The goals of this study were: 1) to develop a translated and culturally-adapted Brazilian-Portugese version of the Kinesthetic and Visual Motor Imagery Questionnaire (KVIQ20-P); 2) to evaluate the psychometric characteristics of the scale in a group of patients with stroke and in an age-matched control group; 3) to compare the KVIQ20 performance between the two groups. Test-retest, inter-rater reliabilities, and internal consistencies were evaluated in 40 patients with stroke and 31 healthy participants. In the stroke group, ICC confidence intervals showed excellent test-retest and inter-rater reliabilities. Cronbach's alpha also indicated excellent internal consistency. Results for controls were comparable to those obtained in persons with stroke. The excellent psychometric properties of the KVIQ20-P should be considered during the design of studies of motor imagery interventions for stroke rehabilitation.

Background: High-risk pregnancies that require lengthy hospitalization can cause anxiety and stress for pregnant women. Integrative medicine therapies may be beneficial for this population, but have not been widely studied., Purpose: The purpose of this study was to evaluate potential effects of acupuncture, guided imagery, Healing Touch, massage therapy, and reflexology on pain and anxiety of hospitalized pregnant women., Methods: A retrospective analysis of the effects of integrative medicine therapies was conducted; N = 554 individual therapies were provided to hospitalized women with high-risk pregnancies. They included acupuncture (n = 83), guided imagery (n = 71), Healing Touch (n = 119), massage therapy (n = 196), and reflexology (n = 85) over an 18-month period. Pain and anxiety were measured pre- and posttherapy using a scale of 0 to 10, where 0 means no pain or no anxiety and 10 means high pain or high anxiety., Results: Analysis of mean scores of pre- and posttherapies for pain and anxiety found a decrease of pain and anxiety after all of the therapies, ranging from an 84.5% to 61.4% decrease for pain (p < .0001) and a 91% to 70. 9% decrease for anxiety (p < .0001). Overall, patients rated their anxiety higher than pain prior to each therapy., Clinical Implications: Hospitalized pregnant women responded favorably to the therapies. There were no adverse reactions reported. Results suggest potential benefits of integrative medicine therapies for this group of inpatients. Anxiety was more prevalent than pain among hospitalized pregnant women who received integrative medicine therapy.

Objectives: Imagery is known to be a powerful means of stimulating various physiological processes and is increasingly used within standard psychological therapies. Compassion-focused imagery (CFI) has been used to stimulate affiliative emotion in people with mental health problems. However, evidence suggests that self-critical individuals may have particular difficulties in this domain with single trials. The aim of the present study was to further investigate the role of self-criticism in responsiveness to CFI by specifically pre-selecting participants based on trait self-criticism., Design: Using the Forms of Self-Criticism/Self-Reassuring Scale, 29 individuals from a total sample of 139 were pre-selected to determine how self-criticism impacts upon an initial instance of imagery., Methods: All participants took part in three activities: a control imagery intervention (useable data N = 25), a standard CFI intervention (useable data N = 25), and a non-intervention control (useable data N = 24). Physiological measurements (alpha amylase) as well as questionnaire measures of emotional responding (i.e., the Positive and Negative Affect Schedule, the Types of Positive Affect Scale, and the State Adult Attachment Scale) were taken before and after the different interventions., Results: Following both imagery interventions, repeated measures analyses revealed that alpha amylase increased significantly for high self-critics compared with low self-critics. High self-critics (HSC) also reported greater insecurity on entering the imagery session and more negative CFI experiences compared with low self-critics., Conclusions: Data demonstrate that HSC respond negatively to imagery interventions in a single trial. This highlights that imagery focused therapies (e.g., CFI) need interventions that manage fears, blocks, and resistances to the techniques, particularly in HSC., Practitioner Points: An initial instance of imagery (e.g., CFI) can be frightening for people who have a tendency to be self-critical. This research provides examples of physiological and emotional responses to imagery type therapies in high and low self-critics, and associated clinical implications. Therapists may find it helpful to be mindful that when introducing imagery based therapies, highly self-critical patients need interventions that manage fears, blocks, and resistances to the techniques., (© 2014 The British Psychological Society.)

Background: Previous research has demonstrated modest benefits from music-based interventions, specifically music and imagery interventions, during cancer care. However, little attention has been paid to measuring the benefits of music-based interventions using measurement instruments specifically designed to account for the multidimensional nature of music-imagery experiences., Objective: The purpose of this study was to describe the development of, and psychometrically evaluate, the Music Therapy Self-Rating Scale (MTSRS) as a measure for cancer patients engaged in supportive music and imagery interventions., Methods: An exploratory factor analysis using baseline data from 76 patients who consented to participate in a music-based intervention study during chemotherapy., Results: Factor analysis of 14 items revealed four domains: Awareness of Body, Emotionally Focused, Personal Resources, and Treatment Specific. Internal reliability was excellent (Cronbach alphas ranging from 0.75 to 0.88) and construct and divergent-discriminant validity supported., Conclusions: The MTSRS is a psychometrically sound, brief instrument that captures essential elements of patient experience during music and imagery interventions., (© the American Music Therapy Association 2015. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)