{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T14:41:38Z","timestamp":1792593698750,"version":"4.5.0"},"reference-count":26,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:00:00Z","timestamp":1792540800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["American Journal of Occupational Therapy"],"abstract":"<jats:sec>\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Mirror 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the changes in clinician acceptability, feasibility, adoption, and patient reach of MTMI over 12 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective, single-site implementation evaluation guided by implementation science frameworks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>A free-standing inpatient rehabilitation hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>\n                      Occupational therapists (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200916) and adult inpatients with stroke or similar neurological conditions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>A 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcomes and Measures<\/jats:title>\n                    <jats:p>Therapist 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>AIM and FIM scores remained high across all time points (AIM 4.4\u20134.8; FIM 4.6\u20134.8). 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%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>Multimodal implementation strategies supported high acceptability, feasibility, and clinician adoption of MTMI in inpatient rehabilitation. Patient reach remained modest.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>What This Article Adds<\/jats:title>\n                    <jats:p>This study provides practical, context-specific guidance for integrating MTMI into inpatient rehabilitation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19437676261495433","type":"journal-article","created":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T14:02:37Z","timestamp":1792591357000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Implementing Mirror Therapy and Mental Imagery for Stroke Inpatient Rehabilitation: Adoption, Acceptability, and Feasibility"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-0020-3026","authenticated-orcid":false,"given":"Jessica","family":"Schmidt","sequence":"first","affiliation":[{"name":"Department of Occupational Therapy, Concordia University of Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1773-7732","authenticated-orcid":false,"given":"Elizabeth","family":"Khoury","sequence":"additional","affiliation":[{"name":"Froedtert Bluemound Rehabilitation Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gretl","family":"Sherburne","sequence":"additional","affiliation":[{"name":"Froedtert Bluemound Rehabilitation Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7972-6124","authenticated-orcid":false,"given":"Lauren","family":"Dittburner","sequence":"additional","affiliation":[{"name":"Froedtert Bluemound Rehabilitation Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam R.","family":"Rafferty","sequence":"additional","affiliation":[{"name":"Strength + Endurance Lab, Shirley Ryan AbilityLab"},{"name":"Northwestern University, Chicago"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2210-7365","authenticated-orcid":false,"given":"Jessica","family":"Edelstein","sequence":"additional","affiliation":[{"name":"Strength + Endurance Lab, Shirley Ryan AbilityLab"},{"name":"Northwestern University, Chicago"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,21]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(99)00920-4"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40359-015-0089-9"},{"key":"e_1_3_3_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2010.07.009"},{"key":"e_1_3_3_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2377-10-74"},{"key":"e_1_3_3_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-014384"},{"key":"e_1_3_3_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s43058-024-00676-8"},{"key":"e_1_3_3_8_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.89.9.1322"},{"key":"e_1_3_3_9_1","unstructured":"Google. (2025). Gemini 2.5 Flash [Large language model]. https:\/\/gemini.google.com"},{"key":"e_1_3_3_10_1","doi-asserted-by":"publisher","DOI":"10.5014\/ajot.2023.077501"},{"key":"e_1_3_3_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2024-095290"},{"key":"e_1_3_3_12_1","doi-asserted-by":"publisher","DOI":"10.5014\/ajot.2020.035485"},{"key":"e_1_3_3_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-021-01178-0"},{"key":"e_1_3_3_14_1","unstructured":"OpenAI. (2025). ChatGPT [Large language model]. https:\/\/chatgpt.com\/"},{"key":"e_1_3_3_15_1","doi-asserted-by":"publisher","DOI":"10.1191\/026921501672063235"},{"issue":"8096","key":"e_1_3_3_16_1","article-title":"Standards for reporting implementation studies (StaRI) statement","volume":"356","author":"Pinnock H.","year":"2017","unstructured":"Pinnock H., Barwick M., Carpenter C. R., Eldridge S., Grandes G., Griffiths C. J., Rycroft-Malone J., Meissner P., Murray E., Patel A. (2017). Standards for reporting implementation studies (StaRI) statement. BMJ, 356(8096). https:\/\/doi.org\/10.1136\/bmj.i6795","journal-title":"BMJ"},{"key":"e_1_3_3_17_1","doi-asserted-by":"publisher","DOI":"10.23736\/S1973-9087.16.04215-5"},{"issue":"21","key":"e_1_3_3_18_1","first-page":"1","article-title":"A refined compilation of implementation strategies: Results from the Expert Recommendations for Implementing Change (ERIC) project","volume":"10","author":"Powell B. J.","year":"2015","unstructured":"Powell B. J., Waltz T. J., Chinman M. J., Damschroder L. J., Smith J. L., Matthieu M. M., Proctor E. K., Kirchner J. E. (2015). A refined compilation of implementation strategies: Results from the Expert Recommendations for Implementing Change (ERIC) project. Implementation Science, 10(21), 1\u201314. https:\/\/doi.org\/10.1186\/s13012-015-0209-1","journal-title":"Implementation Science"},{"key":"e_1_3_3_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jht.2010.11.002"},{"key":"e_1_3_3_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10488-010-0319-7"},{"key":"e_1_3_3_21_1","unstructured":"Reflex Pain Management Ltd. (2011). Orientate \u2013 Pain management (Version 1.8.0) [Mobile app]. App Store. https:\/\/apps.apple.com\/us\/app\/orientate-pain-management\/id479540062"},{"key":"e_1_3_3_22_1","unstructured":"Saebo. (2019). SaeboMind exercises: Mental practice exercises. https:\/\/saebomind.saebo.com\/248365"},{"key":"e_1_3_3_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-017-0631-7"},{"key":"e_1_3_3_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-020-01041-8"},{"key":"e_1_3_3_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2020.09.391"},{"key":"e_1_3_3_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-017-0635-3"},{"key":"e_1_3_3_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroscience.2018.06.044"}],"container-title":["American Journal of Occupational Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19437676261495433","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/19437676261495433","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19437676261495433","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T14:02:40Z","timestamp":1792591360000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/19437676261495433"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,21]]},"references-count":26,"alternative-id":["10.1177\/19437676261495433"],"URL":"https:\/\/doi.org\/10.1177\/19437676261495433","relation":{},"ISSN":["1943-7676","1943-7676"],"issn-type":[{"value":"1943-7676","type":"print"},{"value":"1943-7676","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,21]]},"article-number":"19437676261495433"}}