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Perspectives of stroke survivors and informal caregivers on home-based mental practice for upper limb recovery after stroke: a qualitative co-design study

Lookup NU author(s): Dr Daniel EavesORCiD, Dr Ryc AquinoORCiD

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).

Abstract

In this qualitative study, we explored the views of stroke survivors and informal caregivers regarding three types ofmental practice for upper limb recovery: (1) action observation (AO); (2) motor imagery (MI); and (3) combinedaction observation and motor imagery (AO + MI). Semistructured interviews and focus groups were conductedbetween December 2021 and October 2022 with 23 participants (13 caregivers and 10 stroke survivors).Thematicanalysis generated three higher-order themes: (1) Mental practice: understanding and recent experience. Althoughcomprehension of AO, MI, and AO + MI varied, participants could provide clear, jargon-free explanations of thesemethods. (2) Feasibility of home-based training. Caregivers often felt overburdened, confused, and unsupported inhome-based care but considered mental practice education useful for rehabilitation. (3) User perspectives on a digitalprototype (Webapp). Participants viewed the WebApp interface as overly text-heavy and recommended a morevisually engaging design. This study provides new insights into stroke survivors’ and caregivers’ understanding andperceptions of mental practice and highlights the potential of co-designed digital resources to enhance engagement andsupport home-based rehabilitation. These findings will inform the iterative refinement of mental practice materials for future feasibility and acceptability testing in chronic stroke survivors.

Publication metadata

Author(s): Lin D, Eaves DL, Gibbons T, Aquino MRJ, Edwards MGE, Poliakoff E, Bek J, Emerson JR

Publication type: Article

Publication status: Published

Journal: Neuropsychological Rehabilitation

Year: 2026

Volume: 36

Issue: 6

Pages: 1122-1161

Online publication date: 27/10/2025

Acceptance date: 14/10/2025

Date deposited: 04/11/2025

ISSN (print): 0960-2011

Publisher: Routledge

URL: https://doi.org/10.1080/09602011.2025.2577376

DOI: 10.1080/09602011.2025.2577376

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