OBJECTIVE: To determine whether motor imagery during the immobilization period after flexor tendon injury results in a faster recovery of central mechanisms of hand function. DESIGN: Randomized controlled trial. SETTING: Tertiary referral hospital. PARTICIPANTS: Patients (n = 28) after surgical flexor tendon repair were assigned to either an intervention group or a control group. INTERVENTION: Kinesthetic motor imagery of finger flexion movements during the postoperative dynamic splinting period. MAIN OUTCOME MEASURES: The central aspects of hand function were measured with a preparation time test of finger flexion in which subjects pressed buttons as fast as possible following a visual stimulus. Additionally, the following hand function modalities were recorded: Michigan Hand Questionnaire, visual analog scale for hand function, kinematic analysis of drawing, active total motion, and strength. RESULTS: After the immobilization period, the motor imagery group demonstrated significantly less increase of preparation time than the control group (p = 0.024). There was no significant influence of motor imagery on the other tested hand function (p > 0.05). All tests except kinematic analysis (p = 0.570) showed a significant improvement across time after the splinting period (p <= 0.001). CONCLUSIONS: Motor imagery significantly improves central aspects of hand function, namely movement preparation time, while other modalities of hand function appear to be unaffected.

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