Effects of motor imagery training of Parkinson's disease: a protocol for a randomized clinical trial

Isaíra Almeida Pereira da Silva Nascimento, Lorenna Marques de Melo Santiago, Aline Alves de Souza, Camila de Lima Pegado, Tatiana Souza Ribeiro, Ana Raquel Rodrigues Lindquist, Isaíra Almeida Pereira da Silva Nascimento, Lorenna Marques de Melo Santiago, Aline Alves de Souza, Camila de Lima Pegado, Tatiana Souza Ribeiro, Ana Raquel Rodrigues Lindquist

Abstract

Background: Gait disorders in individuals with Parkinson's disease (PD) may be associated with alterations in the motor control system and aggravated by psychoemotional and cognitive issues. Therapeutic strategies aimed at self-perception and motor regulation seem to be promising. Motor imagery (MI) has been shown to be one of these strategies, but there is still no clear evidence of its applicability in this population. The aim of this trial is to determine the effects of motor-imagery training on the gait and electroencephalographic activity of individuals with PD.

Methods/design: The sample will consist of 40 individuals, aged between 45 and 75 years, in the mild and moderate phase of the disease, with the ability to generate voluntary mental images. They will be assessed for cognitive level, degree of physical disability, mental-image clarity, kinematic gait variables, electroencephalographic activity and mobility. Next, subjects will be randomly assigned to an experimental group (EG) and a control group (CG). The EG will perform motor imagery and gait, while the CG will only engage in gait exercises. Twelve training sessions will be conducted lasting up to 90 min each, three times a week, for 4 weeks. The subjects will be reassessed on the kinematic variables of gait, electroencephalographic activity and mobility at 1, 7 and 30 days after the final training session.

Discussion: The results may provide an important advance in neurological rehabilitation where an easy-access and low-cost intervention may help to improve gait, electroencephalographic activity and mobility in individuals with PD.

Trial registration: Clinicaltrials.gov, ID: NCT03439800. Registered on 15 November 2017.

Keywords: Cerebral activation; Neurological gait disorders; Parkinson’s disease; Rehabilitation.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The schedule of enrollment, interventions and assessments demonstrated in the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) Figure
Fig. 2
Fig. 2
The schematic study design

References

    1. Iansek R, Danoudis M, Bradfield N. Gait and cognition in Parkinson’s disease: implications for rehabilitation. Rev Neurosci. 2013;24(3):293–300. doi: 10.1515/revneuro-2013-0006.
    1. Nieuwboer A, Kwakkel G, Rochester L, et al. Cueing training in the home improves gait-related mobility in Parkinson’s disease: the RESCUE trial. J Neurol Neurosurg Psychiatry. 2007;78:134–140. doi: 10.1136/jnnp.200X.097923.
    1. Lim I, Van Wegan E, Jones D, Rochester L, Nieuwboer A, Willems A, et al. Does cueing training improve physical activity in patients with Parkinson’s disease? Neurorehabil Neural Repair. 2010;24(5):469–7727. doi: 10.1177/1545968309356294.
    1. Cohen OS, Vakil E, Tanne D, Molshatzki N, Nitsan Z, Hassin-Baer S. The Frontal Assessment Battery as a tool for evaluation of frontal lobe dysfunction in patients with Parkinson disease. J Geriatr Psychiatry Neurol. 2012;25(2):71–77. doi: 10.1177/0891988712445087.
    1. Frazzitta G, Maestri R, Uccellini D, Bertotti G, Abelli P. Rehabilitation treatment of gait in patients with Parkinson’s disease with freezing: a comparison between two physical therapy protocols using visual and auditory cues with or without treadmill training. Mov Disord. 2009;24(8):1139–1143. doi: 10.1002/mds.22491.
    1. Spaulding SJ, Barber B, Colby M, Cormack B, Mick T, Jenkins ME. Cueing and gait improvement among people with Parkinson’s disease: a meta-analysis. Arch Phys Med Rehabil. 2013;94(3):562–570. doi: 10.1016/j.apmr.2012.10.026.
    1. Bočková M, Rektor I. Impairment of brain functions in Parkinson’s disease reflected by alterations in neural connectivity in EEG studies: a viewpoint. Clin Neurophysiol. 2019;130(2):239–247. doi: 10.1016/j.clinph.2018.11.013.
    1. De Vries S, Mulder T. Motor imagery and stroke rehabilitation: a critical discussion. J Rehabil Med. 2007;39(1):5–13. doi: 10.2340/16501977-0020.
    1. Malouin F, Jackson PL, Richards CL. Towards the integration of mental practice in rehabilitation programs. A critical review. Front Hum Neurosci. 2013;7:576. doi: 10.3389/fnhum.2013.00576.
    1. Beisteiner R, Höllinger P, Lindinger G, Lang W, Berthoz A. Mental representations of movements. Brain potentials associated with imagination of hand movements. Electroencephalogr Clin Neurophysiol. 1995;96(2):183–193. doi: 10.1016/0168-5597(94)00226-5.
    1. Pfurtscheller G, Neuper C. Motor imagery activates primary sensorimotor area in humans. Neurosci Lett. 1997;239:65–68. doi: 10.1016/S0304-3940(97)00889-6.
    1. Snijders AH, Leunissen I, Bakker M, Overeem S, Helmich RC, Bloem BR, et al. Gait-related cerebral alterations in patients with Parkinson’s disease with freezing of gait. Brain. 2011;134:59–72. doi: 10.1093/brain/awq324.
    1. Jahn K, Deutschländer A, Stephan T, Kalla R, Wiesmann M, Strupp M, et al. Imaging human supraspinal locomotor centers in brainstem and cerebellum. Neuroimage. 2008;39(2):786–792. doi: 10.1016/j.neuroimage.2007.09.047.
    1. La Fougère C, Zwergal A, Rominger A, Förster S, Fesl G, Dieterich M, et al. Real versus imagined locomotion: a [18F]-FDG PET-fMRI comparison. Neuroimage. 2010;50:1589–1598. doi: 10.1016/j.neuroimage.2009.12.060.
    1. Nilsen DM, Gillen G, Gordon AM. Use of mental practice to improve upper-limb recovery after stroke: a systematic review. Am J Occup Ther. 2010;64(5):695–708. doi: 10.5014/ajot.2010.09034.
    1. Rottschy C, Kleiman A, Dogan I, Langner R, Mirzazade S, Kronenbuerger M, et al. Diminished activation of motor working-memory networks in Parkinson’s disease. PLoS One. 2013;8(4):e61786. doi: 10.1371/journal.pone.0061786.
    1. Tamir R, Dickstein R, Huberman M. Integration of motor imagery and physical practice in group treatment applied to subjects with Parkinson’s disease. Neurorehabil Neural Repair. 2007;21(1):68–75. doi: 10.1177/1545968306292608.
    1. El-Wishy AA, Fayez ES. Effect of locomotor imagery training added to physical therapy program on gait performance in Parkinson patients: a randomized controlled study. Egypt J Neurol Psychiatry Neurosurg. 2013;50(1)):31.
    1. Santiago LM, de Oliveira DA, de Macêdo Ferreira LG, de Brito Pinto HY, Spaniol AP, de Lucena Trigueiro LC, Ribeiro TS, de Sousa AV, Piemonte ME, Lindquist AR. Immediate effects of adding mental practice to physical practice on the gait of individuals with Parkinson’s disease: randomized clinical trial. NeuroRehabilitation. 2015;37(2):263–271. doi: 10.3233/NRE-151259.
    1. Braun S, Beurskens A, Kleynen M, Schols J, Wade D. Rehabilitation with mental practice has similar effects on mobility as rehabilitation with relaxation in people with Parkinson’s disease: a multicentre randomised trial. J Physiother. 2011;57(1):27–34. doi: 10.1016/S1836-9553(11)70004-2.
    1. Sullivan KM, Dean A, Soe MM. On academics: OpenEpi: a web-based epidemiologic and statistical calculator for public health. Public Health Rep. 2009;124(3):471–474. doi: 10.1177/003335490912400320.
    1. Shenkman ML, Clark K, Xie T, Kuchibhatla M, Shinberg M, Ray L. Spinal movement and performance of standing reach task in participants with and without Parkinson disease. Phys Ther. 2001;81:1400–1411. doi: 10.1093/ptj/81.8.1400.
    1. Brucki SMD, Nitrini R, Caramelli P, et al. Sugestões para o uso do Mini exame do estado mental no Brasil. Arq Neuropsiquiatr. 2003;61(3–8):777–781. doi: 10.1590/S0004-282X2003000500014.
    1. Williams SE, Cumming J, Ntoumanis N, Nordin-Bates SM, Ramsey R, Hall C. Further validation and development of the movement imagery questionnaire. J Sport Exerc Psychol. 2012;34(5):621–646. doi: 10.1123/jsep.34.5.621.
    1. Malachias MVB, Souza WKSB, Plavnik FL, Rodrigues CIS, Brandão AA, Neves MFT, et al. 7ª Diretriz Brasileira de Hipertensão Arterial. Arq Bras Cardiol. 2016;107:3 Suppl 3:1–3 Suppl 383.
    1. Aspinall P, Mavros P, Coyne R, Roe J. The urban brain: analyzing outdoor physical activity with mobile EEG. Br J Sports Med. 2015;49(4):272–276. doi: 10.1136/bjsports-2012-091877.
    1. Badcock NA, Mousikou P, Mahajan Y, de Lissa P, Thie J, McArthur G. Validation of the Emotiv EPOC® EEG gaming system for measuring research quality auditory ERPs. Peer J. 2013;1:e38. doi: 10.7717/peerj.38.
    1. Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39:142–148. doi: 10.1111/j.1532-5415.1991.tb01616.x.

Source: PubMed

Sponsors et collaborateurs

Les conditions médicales

Interventions en matière de drogue

3
S'abonner