Exploring the views of chronic stroke survivors and informal caregivers on different types of mental practice for promoting upper-limb recovery in a home-based setting: A qualitative study

This qualitative study explored the views of stroke survivors and informal caregiversregarding three types of mental practice for promoting upper-limb recovery: (1) actionobservation (AO); (2) motor imagery (MI); and (3) combined action observation andmotor imagery (AO+MI). We conducted semi-structured interviews and focus groupsbetween December 2021 - October 2022, involving 23 participants: 13 caregivers whosupport a stroke survivor, and 10 stroke survivors. Thematic analysis revealed threehigher-order themes: (1) Mental practice: understanding and experience. Although,levels of comprehension of what the AO, MI and AO+MI protocols involved was mixedacross caregivers and stroke survivors, participants could articulate clear, simple andjargon-free explanations of these methods. (2) Home-based training experience.Caregivers felt overburdened, confused, and unsupported in home-based care butbelieved education on mental practice was helpful for rehabilitation. (3) Userperspectives on a digital prototype (Webapp). The Webapp interface was seen asoverly text-heavy and a more visually appealing design was suggested. This studyshed new light on perception and understanding of mental practice in stroke survivorsand caregivers. These insights will inform the iterative development of mental practicematerials for future feasibility and acceptability testing in a home-based interventionfor upper-limb recovery in chronic stroke survivors.