Implementing Mirror Therapy and Mental Imagery for Stroke Inpatient Rehabilitation: Adoption, Acceptability, and...

ImportanceMirror therapy and mental imagery (MTMI) are evidence-based interventions for upper extremity motor recovery after stroke, yet they remain underused in clinical practice. Implementation science offers a systematic approach in improving uptake in real-world settings.ObjectiveTo evaluate the changes in clinician acceptability, feasibility, adoption, and patient reach of MTMI over 12 months.DesignProspective, single-site implementation evaluation guided by implementation science frameworks.SettingA free-standing inpatient rehabilitation hospital.ParticipantsOccupational therapists (n = 16) and adult inpatients with stroke or similar neurological conditions.InterventionA therapist-led, 60 min MTMI group was delivered two to three times weekly. Six implementation barriers were identified. Implementation strategies: clinician education, training, support, and infrastructure changes.Outcomes and MeasuresTherapist acceptability and feasibility were measured using the Acceptability of Intervention Measure (AIM) and Feasibility of Intervention Measure (FIM) at baseline, 4 months, and 12 months. Therapist adoption was assessed through training records and self-report. Patient reach was derived from attendance-tracking and hospital-admission data.ResultsAIM and FIM scores remained high across all time points (AIM 4.4-4.8; FIM 4.6-4.8). Adoption increased over time: therapists trained to lead MTMI rose from 11% to 61%, and self-reported MTMI use increased from 63% to 92%. The mean monthly patient reach was 39%.Conclusions and RelevanceMultimodal implementation strategies supported high acceptability, feasibility, and clinician adoption of MTMI in inpatient rehabilitation. Patient reach remained modest.What This Article AddsThis study provides practical, context-specific guidance for integrating MTMI into inpatient rehabilitation.