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Wakefield CJ, Smith D, Hogard E, Ellis R, Parry C. Using PETTLEP imagery as a simulation technique in nursing: Research and guidelines. Nurse Educ Pract 2020; 43:102700. [PMID: 32028081 DOI: 10.1016/j.nepr.2020.102700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 01/07/2020] [Accepted: 01/15/2020] [Indexed: 11/25/2022]
Abstract
One of the most valuable skill sets developed in nurse education is the ability to develop the clinical and practical skills learned. This can take various forms such as university-based practice, simulation and direct experience with patients. To this end imagery, a process where all of the senses are used to create or recreate an experience in the mind, could represent simulated practice of clinical skills. Research on imagery has indicated that the technique, when used to assist in the performance of skill based procedures carried out by nurses can be beneficial. However, guidelines are lacking in this area of simulated practice. In this article, we review current research on the topic of imagery in enhancing skilled performance and outline a model that can assist in conducting interventions. Furthermore, we consider how this could be implemented within a nursing environment to produce beneficial performance effects in both pre-registration and registered nurses.
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Affiliation(s)
- Caroline J Wakefield
- School of Health Sciences, Liverpool Hope University, Hope Park, Taggart Avenue, Liverpool, L16 9JD, UK.
| | - Dave Smith
- Department of Sport and Exercise Sciences, Manchester Metropolitan University, Crewe Road, Crewe, CW1 5DU, UK
| | - Elaine Hogard
- Human Sciences Division, Northern Ontario School of Medicine at Lakehead University, 955 Oliver Road, Thunder Bay, ON, P7B 5E1, Canada
| | - Roger Ellis
- School of Psychology, Ulster University, Cromore Road, Coleraine, Co. Londonderry, BT52 1SA, UK
| | - Clare Parry
- Department of Sport and Exercise Sciences, University of Chester, Parkgate Road, Chester, CH1 4BJ, UK
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Oudiette D, Dodet P, Ledard N, Artru E, Rachidi I, Similowski T, Arnulf I. REM sleep respiratory behaviours mental content in narcoleptic lucid dreamers. Sci Rep 2018; 8:2636. [PMID: 29422603 PMCID: PMC5805737 DOI: 10.1038/s41598-018-21067-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 01/29/2018] [Indexed: 11/13/2022] Open
Abstract
Breathing is irregular during rapid eye-movement (REM) sleep, whereas it is stable during non-REM sleep. Why this is so remains a mystery. We propose that irregular breathing has a cortical origin and reflects the mental content of dreams, which often accompany REM sleep. We tested 21 patients with narcolepsy who had the exceptional ability to lucid dream in REM sleep, a condition in which one is conscious of dreaming during the dream and can signal lucidity with an ocular code. Sleep and respiration were monitored during multiple naps. Participants were instructed to modify their dream scenario so that it involved vocalizations or an apnoea, -two behaviours that require a cortical control of ventilation when executed during wakefulness. Most participants (86%) were able to signal lucidity in at least one nap. In 50% of the lucid naps, we found a clear congruence between the dream report (e.g., diving under water) and the observed respiratory behaviour (e.g., central apnoea) and, in several cases, a preparatory breath before the respiratory behaviour. This suggests that the cortico-subcortical networks involved in voluntary respiratory movements are preserved during REM sleep and that breathing irregularities during this stage have a cortical/subcortical origin that reflects dream content.
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Affiliation(s)
- Delphine Oudiette
- Sorbonne Université, IHU@ICM, INSERM, CNRS UMR7225, équipe MOV'IT, F-75013 Paris, France.,AP-HP, Hôpital Pitié-Salpêtrière, Service des Pathologies du Sommeil (Département "R3S"), F-75013 Paris, France
| | - Pauline Dodet
- AP-HP, Hôpital Pitié-Salpêtrière, Service des Pathologies du Sommeil (Département "R3S"), F-75013 Paris, France
| | - Nahema Ledard
- AP-HP, Hôpital Pitié-Salpêtrière, Service des Pathologies du Sommeil (Département "R3S"), F-75013 Paris, France
| | - Emilie Artru
- AP-HP, Hôpital Pitié-Salpêtrière, Service des Pathologies du Sommeil (Département "R3S"), F-75013 Paris, France
| | - Inès Rachidi
- AP-HP, Hôpital Pitié-Salpêtrière, Service des Pathologies du Sommeil (Département "R3S"), F-75013 Paris, France
| | - Thomas Similowski
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, F-75013 Paris, France.,AP-HP, Hôpital Pitié-Salpêtrière, Service de Pneumologie et Réanimation Médicale (Département "R3S"), F-75013, Paris, France
| | - Isabelle Arnulf
- Sorbonne Université, IHU@ICM, INSERM, CNRS UMR7225, équipe MOV'IT, F-75013 Paris, France. .,AP-HP, Hôpital Pitié-Salpêtrière, Service des Pathologies du Sommeil (Département "R3S"), F-75013 Paris, France.
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Peixoto Pinto T, Mello Russo Ramos M, Lemos T, Domingues Vargas C, Imbiriba LA. Is heart rate variability affected by distinct motor imagery strategies? Physiol Behav 2017; 177:189-195. [PMID: 28476285 DOI: 10.1016/j.physbeh.2017.05.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 03/22/2017] [Accepted: 05/02/2017] [Indexed: 11/30/2022]
Abstract
Although some studies have reported significant changes in autonomic responses according to the perspective-taking during motor imagery [first person perspective (1P) and third person perspective (3P)], investigations on how the strategies adopted to mentally simulate a given movement affect the heart rate variability (HRV) seem so far unexplored. Twenty healthy subjects mentally simulated the movement of middle-finger extension in 1P and 3P, while electrocardiogram was recorded. After each task, the level of easiness was self-reported. Motor imagery ability was also assessed through the revised version of Movement Imagery Questionnaire (MIQ-R) and a mental chronometry index. The traditional measures of HRV in the time- and frequency-domain were compared between 1P and 3P tasks by using Student's t-test for dependent samples. The MIQ-R results showed that subjects had the same facility to imagine movements in 1P or 3P. The mental chronometry index revealed a similar temporal course only between 1P and execution, while the 3P strategy had a shorter duration. Additionally, the subjective report was similar between the experimental tasks. Regarding the HRV measures, the low frequency component, in log-transformed unit, was significantly higher (p=0.017) in 1P than 3P, suggesting a higher activity of the sympathetic system during 1P. This log-transformed HRV parameter seems to be more sensitive than normalized values for the assessment of the motor imagery ability, together with questionnaires, scales and mental chronometry.
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Affiliation(s)
- Talita Peixoto Pinto
- Núcleo de Estudos do Movimento Humano (NEMoH), Escola de Educação Física e Desportos, Universidade Federal do Rio de Janeiro, Brazil; Laboratorio di Ingegneria del Sistema Neuromuscolare (LISiN), Politecnico di Torino, Torino, Italy.
| | - Maitê Mello Russo Ramos
- Laboratório de Neurobiologia II, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Brazil
| | - Thiago Lemos
- Laboratório de Neurobiologia II, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Brazil
| | - Claudia Domingues Vargas
- Laboratório de Neurobiologia II, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Brazil
| | - Luis Aureliano Imbiriba
- Núcleo de Estudos do Movimento Humano (NEMoH), Escola de Educação Física e Desportos, Universidade Federal do Rio de Janeiro, Brazil
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Boulton H, Mitra S. Incomplete inhibition of central postural commands during manual motor imagery. Brain Res 2015; 1624:321-329. [PMID: 26236027 DOI: 10.1016/j.brainres.2015.07.031] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 06/12/2015] [Accepted: 07/18/2015] [Indexed: 11/20/2022]
Abstract
Imagined movements exhibit many of the behavioral and neurophysiological characteristics of executed actions. As a result, they are considered simulations of physical actions with an inhibition mechanism that suppresses overt movement. This inhibition is incomplete, as it does not block autonomic preparation, and it also does not effectively suppress postural adjustments planned in support of imagined movements. It has been suggested that a central inhibition command may fail to suppress postural adjustments because it may not have access to afference-based elaborations of the postural response that occur downstream of central motor planning. Here, we measured changes in the postural response associated with imagining manual reaching movements under varying levels of imagined loading of the arm. We also manipulated stance stability, and found that postural sway reduced with increased (imagined) arm loading when imagining reaching movements from the less stable stance. As there were no afferent signals associated with the loading constraint, these results suggest that postural adjustments can leak during motor imagery because the postural component of the central motor plan is itself not inhibited effectively.
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Affiliation(s)
- Hayley Boulton
- Division of Psychology, Nottingham Trent University, Nottingham NG1 4BU, UK
| | - Suvobrata Mitra
- Division of Psychology, Nottingham Trent University, Nottingham NG1 4BU, UK.
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Boulton H, Mitra S. Body posture modulates imagined arm movements and responds to them. J Neurophysiol 2013; 110:2617-26. [DOI: 10.1152/jn.00488.2013] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Imagined movements are thought to simulate physical ones, with similar behavioral constraints and neurophysiological activation patterns and with an inhibition mechanism that suppresses movement execution. When upper body movements such as reaching with the arm are made from an upright stance, lower body and trunk muscles are also activated to maintain body posture. It is not clear to what extent parameters of imagined manual movements are sensitive to the postural adjustments their execution would necessitate, nor whether such postural responses are as effectively inhibited as the imagined movements themselves. We asked healthy young participants to imagine reaching movements of the arm while in upright stance, and we measured their self-reported movement times and postural sway during imagined movements. We manipulated mediolateral stance stability and the direction of arm movement (mediolateral or anteroposterior). Imagined arm movements were reportedly slower when subjects were standing in a mediolaterally less stable stance, and the body swayed more when arm movements were imagined in the direction of postural vulnerability. The results suggest that the postural state of the whole body, not just the involved limbs, informs trajectory planning during motor imagery and that measurable adjustments to body posture accompany imagined manual actions. It has been suggested that movement is suppressed during motor imagery by a premotor inhibitory mechanism operating at brain stem or spinal level. Any such inhibition must be incomplete because, for example, it does not eliminate autonomic arousal. Our results suggest that it also does not effectively suppress postural adjustments planned in support of imagined movements.
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Affiliation(s)
- Hayley Boulton
- Department of Psychology, University of Warwick, Coventry, United Kingdom
| | - Suvobrata Mitra
- Department of Psychology, University of Warwick, Coventry, United Kingdom
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Brown R, Kemp U, Macefield V. Increases in muscle sympathetic nerve activity, heart rate, respiration, and skin blood flow during passive viewing of exercise. Front Neurosci 2013; 7:102. [PMID: 23781170 PMCID: PMC3678085 DOI: 10.3389/fnins.2013.00102] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Accepted: 05/23/2013] [Indexed: 12/01/2022] Open
Abstract
The cardiovascular and respiratory effects of exercise have been widely studied, as have the autonomic effects of imagined and observed exercise. However, the effects of observed exercise in the first person have not been documented, nor have direct recordings of muscle sympathetic nerve activity (MSNA) been obtained during observed or imagined exercise. The aim of the current study was to measure blood pressure, heart rate, respiration, skin blood flow, sweat release, and MSNA (via microelectrodes inserted into the common peroneal nerve), during observation of exercise from the first person point of view. It was hypothesized that the moving stimuli would produce robust compensatory increases in the above-mentioned parameters as effectively as those generated by mental imagery and—to a lesser extent—actual exercise. Nine subjects watched a first-person running video, allowing them to view the action from the perspective of the runner rather than viewing someone else perform the exercise. On average, statistically significant increases from baseline during the running phase were seen in heart rate, respiratory rate, skin blood flow, and burst amplitude of MSNA. These results suggest that observation of exercise in the first person is a strong enough stimulus to evoke “physiologically appropriate” autonomic responses that have a purely psychogenic origin.
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Affiliation(s)
- Rachael Brown
- School of Medicine, University of Western Sydney Penrith, NSW, Australia
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Ritz T. Airway responsiveness to psychological processes in asthma and health. Front Physiol 2012; 3:343. [PMID: 22973233 PMCID: PMC3433706 DOI: 10.3389/fphys.2012.00343] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Accepted: 08/08/2012] [Indexed: 12/16/2022] Open
Abstract
Psychosocial factors have been found to impact airway pathophysiology in respiratory disease with considerable consistency. Influences on airway mechanics have been studied particularly well. The goal of this article is to review the literature on airway responses to psychological stimulation, discuss potential pathways of influence, and present a well-established emotion-induction paradigm to study airway obstruction elicited by unpleasant stimuli. Observational studies have found systematic associations between lung function and daily mood changes. The laboratory-based paradigm of bronchoconstrictive suggestion has been used successfully to elicit airway obstruction in a substantial proportion of asthmatic individuals. Other studies have demonstrated modulation of airway responses to standard airway challenges with exercise, allergens, or pharmacological agents by psychological factors. Standardized emotion-induction techniques have consistently shown airway constriction during unpleasant stimulation, with surgery, blood, and injury stimuli being particularly powerful. Findings with various forms of stress induction have been more mixed. A number of methodological factors may account for variability across studies, such as choice of measurement technique, temporal association between stimulation and measurement, and the specific quality and intensity of the stimulus material, in particular the extent of implied action-orientation. Research has also begun to elucidate physiological processes associated with psychologically induced airway responses, with vagal excitation and ventilatory influences being the most likely candidate pathways, whereas the role of specific central nervous system pathways and inflammatory processes has been less studied. The technique of emotion-induction using films has the potential to become a standardized challenge paradigm for the further exploration of airway hyperresponsiveness mediated by central nervous system processes.
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Affiliation(s)
- Thomas Ritz
- Southern Methodist University Dallas, TX, USA
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Abstract
Zusammenfassung. Das Mentale Training im Sinne der planmäßig wiederholten Vorstellung einer motorischen Fertigkeit ist ein zentraler Gegenstand der sportwissenschaftlichen Forschung und eine wichtige Trainingsergänzung in der Sportpraxis. Für das bessere Verständnis der Trainingswirkung wird in diesem Beitrag vorgeschlagen, Mentales Training als Simulation zu verstehen. Der Begriff der Simulation bezieht sich, erstens, auf die neuronale Ebene, also der Aktivierung von motorischen Arealen während der Bewegungsvorstellung. Zweitens, auf die motorische Kontrollebene und der Umsetzung durch interne Modelle, wobei das Vorwärtsmodell als Emulator gesehen wird. Drittens, auf die Wirkungsweise des Mentalen Trainings mit einer Fokussierung auf die Korrektur der zentralen Prozesse anhand der simulierten Rückmeldungen des Emulators. Der Ansatz der Simulation lässt sich auf andere mentale Zustände, die motorische Handlungen abbilden, übertragen und bietet somit einen generellen Erklärungsansatz für motorische Leistungsveränderungen, die durch kognitive Prozesse verursacht werden. Zudem deckt der Simulationsbegriff die flexible und phänomenale Sicht des mental Trainierenden ab. Der Ansatz der Simulation bietet auf verschiedenen Ebenen Vorhersagen, die zukünftige Untersuchungen in diesem Bereich fruchtbar anregen sollten.
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Porro CA, Facchin P, Fusi S, Dri G, Fadiga L. Enhancement of force after action observation: behavioural and neurophysiological studies. Neuropsychologia 2007; 45:3114-21. [PMID: 17681358 DOI: 10.1016/j.neuropsychologia.2007.06.016] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2007] [Revised: 05/30/2007] [Accepted: 06/04/2007] [Indexed: 10/23/2022]
Abstract
We tested here the hypothesis that observing others' actions can facilitate basic aspects of motor performance, such as force production, even if subjects are not required to immediately reproduce the observed actions and if they are not aware that observation can form the basis for procedural training. To this end, we compared in healthy volunteers the effects of repeated actual execution (MOV) or observation (OBS) of a simple intransitive movement (abduction of the right index and middle fingers). In a first experiment, we found that both actual and observational training significantly increased the finger abduction force of both hands. In the MOV group, force increases over pre-training values were significantly higher in the trained than in the untrained hand (50% versus 33%), whereas they were similar for the two hands in the OBS group (32% versus 30%). No force change was found in the control, untrained group. In a second experiment, we found that both training conditions significantly increased the isometric force exerted during right index finger abduction, whereas no post-training change in isometric force was found during abduction of the right little finger. Actual performance, imagination and, to a lower extent, observation of fingers movement enhanced the excitability of the corticospinal system targeting the first dorsal interosseus muscle, as tested by transcranial magnetic stimulation; pre- and post-training effects were of similar magnitude. These results show a powerful, specific role of action observation in motor training, likely exerted through premotor areas, which may prove useful in physiological and rehabilitative conditions.
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Affiliation(s)
- Carlo A Porro
- Dipartimento di Scienze Biomediche, Sezione Fisiologia, University of Modena and Reggio Emilia, Via Campi 287, I-41100 Modena, Italy.
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Guillot A, Collet C. Contribution from neurophysiological and psychological methods to the study of motor imagery. ACTA ACUST UNITED AC 2005; 50:387-97. [PMID: 16271398 DOI: 10.1016/j.brainresrev.2005.09.004] [Citation(s) in RCA: 142] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2005] [Revised: 09/27/2005] [Accepted: 09/27/2005] [Indexed: 11/18/2022]
Abstract
This paper reviews studies on neurophysiological and behavioral methods used to evaluate motor imagery accuracy. These methods can be used when performed in the field and are based on recordings of peripheral indices such as autonomic nervous system or electromyographic activities, mental chronometry and psychological tests. Providing physiological signs that correlate to these types of mental processes may be considered an objective approach for motor imagery analysis. However, although autonomic nervous system activity recording has been shown to match motor imagery in real time, to evaluate its accuracy qualitatively and the individual ability to form mental images, the relationship between physiological responses and mental processes remains an inference. Moreover, electromyographic recordings may be associated with postural control data, but due to inconsistent results, they remain insufficient to solely evaluate motor imagery accuracy. Other techniques traditionally used in psychology and cognitive psychology are questionnaires, "debriefing" with subjects and mental chronometry. Although such methods lead to interesting results, there remains an important part of subjectivity as subjects perform an auto-evaluation of motor imagery accuracy. Similarly, mental chronometry gives information on the ability to preserve temporal organization of movement but does not allow the evaluation of the vividness of mental images. Thus, several methods should be combined to analyze motor imagery accuracy in greater detail. Neurophysiological recordings cannot therefore be considered an alternative but rather a complementary technique to behavioral and psychological methods. The advantages and inconvenient of each technique and the hypotheses that could be tested are discussed.
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Affiliation(s)
- Aymeric Guillot
- Centre de Recherche et d'Innovation sur le Sport, Université Claude Bernard Lyon I-UFR STAPS, 27-29 Boulevard du 11 Novembre 1918, 69622 Villeurbanne Cedex, France.
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