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Bode M, Kalbe E, Liepelt-Scarfone I. Cognition and Activity of Daily Living Function in people with Parkinson's disease. J Neural Transm (Vienna) 2024:10.1007/s00702-024-02796-w. [PMID: 38976044 DOI: 10.1007/s00702-024-02796-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 06/08/2024] [Indexed: 07/09/2024]
Abstract
The ability to perform activities of daily living (ADL) function is a multifaceted construct that reflects functionality in different daily life situations. The loss of ADL function due to cognitive impairment is the core feature for the diagnosis of Parkinson's disease dementia (PDD). In contrast to Alzheimer's disease, ADL impairment in PD can be compromised by various factors, including motor and non-motor aspects. This narrative review summarizes the current state of knowledge on the association of cognition and ADL function in people with PD and introduces the concept of "cognitive ADL" impairment for those problems in everyday life that are associated with cognitive deterioration as their primary cause. Assessment of cognitive ADL impairment is challenging because self-ratings, informant-ratings, and performance-based assessments seldomly differentiate between "cognitive" and "motor" aspects of ADL. ADL function in PD is related to multiple cognitive domains, with attention, executive function, and memory being particularly relevant. Cognitive ADL impairment is characterized by behavioral anomalies such as trial-and-error behavior or task step omissions, and is associated with lower engagement in everyday behaviors, as suggested by physical activity levels and prolonged sedentary behavior. First evidence shows that physical and multi-domain interventions may improve ADL function, in general, but the evidence is confounded by motor aspects. Large multicenter randomized controlled trials with cognitive ADL function as primary outcome are needed to investigate which pharmacological and non-pharmacological interventions can effectively prevent or delay deterioration of cognitive ADL function, and ultimately the progression and conversion to PDD.
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Affiliation(s)
- Merle Bode
- Hertie Institute for Clinical Brain Research, Department of Neurodegenerative Diseases, Eberhard Karls University Tübingen, Hoppe-Seyler Str. 3, 72076, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Elke Kalbe
- Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), University Hospital Cologne, Cologne, Germany
- Medical Faculty, University of Cologne, Cologne, Germany
| | - Inga Liepelt-Scarfone
- Hertie Institute for Clinical Brain Research, Department of Neurodegenerative Diseases, Eberhard Karls University Tübingen, Hoppe-Seyler Str. 3, 72076, Tübingen, Germany.
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany.
- IB-Hochschule, Stuttgart, Germany.
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Singer T, Fahey P, Liu KPY. Effectiveness of Motor Imagery in the Rehabilitation of People With Parkinson's Disease: A Systematic Review and Meta-Analysis. Neurorehabil Neural Repair 2024; 38:460-475. [PMID: 38686907 DOI: 10.1177/15459683241246493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
BACKGROUND AND OBJECTIVE With more research completed using Motor imagery (MI) in people with Parkinson's disease, this study gathered and synthesized evidence on the use of MI for Parkinson's disease in improving rehabilitation outcomes. METHODS Medical Literature Analysis and Retrieval System Online, Embase, Web of Science, The Cochrane Library, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, and Scopus were searched from inception to May 2023. We included randomized controlled trials that examine the effects of MI on individuals with Parkinson's disease. Two reviewers selected articles and extracted study characteristics and results independently. The Physiotherapy Evidence Database scale was used to assess the methodological quality. Mean differences and 95% confidence intervals were calculated. Heterogeneity was assessed using the I2 statistic. RESULTS Thirteen articles with 12 studies were included, involving 320 individuals with Parkinson's disease, with moderate to high methodological quality (mean = 6.62/10). Compared with the control group, 3 articles reported significant greater improvements in cognitive function, 7 reported significant greater improvement in motor function, 1 article reported significant greater improvement in quality of life, and 1 reported significant greater confidence in daily task performance. No statistically significant effects were found in the meta-analyses. Conclusion. Results of individual articles were in favor of the MI intervention. No statistically significant results were found in the meta-analyses. This might be due to the small number of studies and the heterogeneity of interventions and outcome measures used. MI may be effective in improving some rehabilitation outcomes, but meta-analytic evidence is lacking. More research with larger sample size and less heterogeneous samples, interventions, and outcome measures, is warranted. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number CRD42021230556.
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Affiliation(s)
- Tabitha Singer
- School of Health Sciences, Western Sydney University, Penrith, NSW, Australia
- Brain Injury Rehabilitation Unit, Liverpool Hospital, South Western Sydney Local Health District, NSW, Australia
| | - Paul Fahey
- School of Health Sciences, Western Sydney University, Penrith, NSW, Australia
- Translational Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Karen P Y Liu
- School of Health Sciences, Western Sydney University, Penrith, NSW, Australia
- Translational Health Research Institute, Western Sydney University, Penrith, NSW, Australia
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR
- South Western Sydney Local Health District, NSW, Australia
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Tien HP, Chang EC. Inequivalent and uncorrelated response priming in motor imagery and execution. Front Psychol 2024; 15:1363495. [PMID: 38860046 PMCID: PMC11163096 DOI: 10.3389/fpsyg.2024.1363495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 05/13/2024] [Indexed: 06/12/2024] Open
Abstract
Introduction Theoretical considerations on motor imagery and motor execution have long been dominated by the functional equivalence view. Previous empirical works comparing these two modes of actions, however, have largely relied on subjective judgments on the imagery process, which may be exposed to various biases. The current study aims to re-examine the commonality and distinguishable aspects of motor imagery and execution via a response repetition paradigm. This framework aims to offer an alternative approach devoid of self-reporting, opening the opportunity for less subjective evaluation of the disparities and correlations between motor imagery and motor execution. Methods Participants performed manual speeded-choice on prime-probe pairs in each trial under three conditions distinguished by the modes of response on the prime: mere observation (Perceptual), imagining response (Imagery), and actual responses (Execution). Responses to the following probe were all actual execution of button press. While Experiment 1 compared the basic repetition effects in the three prime conditions, Experiment 2 extended the prime duration to enhance the quality of MI and monitored electromyography (EMG) for excluding prime imagery with muscle activities to enhance specificity of the underlying mechanism. Results In Experiment 1, there was no significant repetition effect after mere observation. However, significant repetition effects were observed in both imagery and execution conditions, respectively, which were also significantly correlated. In Experiment 2, trials with excessive EMG activities were excluded before further statistical analysis. A consistent repetition effect pattern in both Imagery and Execution but not the Perception condition. Now the correlation between Imagery and Execution conditions were not significant. Conclusion Findings from the current study provide a novel application of a classical paradigm, aiming to minimize the subjectivity inherent in imagery assessments while examining the relationship between motor imagery and motor execution. By highlighting differences and the absence of correlation in repetition effects, the study challenges the functional equivalence hypothesis of imagery and execution. Motor representations of imagery and execution, when measured without subjective judgments, appear to be more distinguishable than traditionally thought. Future studies may examine the neural underpinnings of the response repetition paradigm to further elucidating the common and separable aspects of these two modes of action.
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Affiliation(s)
- Hsin-Ping Tien
- Action and Cognition Laboratory, Institute of Cognitive Neuroscience, College of Health Sciences and Technology, National Central University, Taoyuan, Taiwan
- Taiwan International Graduate Program in Interdisciplinary Neuroscience, National Central University and Academia Sinica, Taipei, Taiwan
| | - Erik C. Chang
- Action and Cognition Laboratory, Institute of Cognitive Neuroscience, College of Health Sciences and Technology, National Central University, Taoyuan, Taiwan
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Saruco E, Saimpont A, Di Rienzo F, De Witte B, Laroyenne I, Matéo F, Lapenderie M, Solard SG, Perretant I, Frenot C, Jackson PL, Guillot A. Towards efficient motor imagery interventions after lower-limb amputation. J Neuroeng Rehabil 2024; 21:55. [PMID: 38622634 PMCID: PMC11017566 DOI: 10.1186/s12984-024-01348-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 03/22/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND The therapeutic benefits of motor imagery (MI) are now well-established in different populations of persons suffering from central nervous system impairments. However, research on similar efficacy of MI interventions after amputation remains scarce, and experimental studies were primarily designed to explore the effects of MI after upper-limb amputations. OBJECTIVES The present comparative study therefore aimed to assess the effects of MI on locomotion recovery following unilateral lower-limb amputation. METHODS Nineteen participants were assigned either to a MI group (n = 9) or a control group (n = 10). In addition to the course of physical therapy, they respectively performed 10 min per day of locomotor MI training or neutral cognitive exercises, five days per week. Participants' locomotion functions were assessed through two functional tasks: 10 m walking and the Timed Up and Go Test. Force of the amputated limb and functional level score reflecting the required assistance for walking were also measured. Evaluations were scheduled at the arrival at the rehabilitation center (right after amputation), after prosthesis fitting (three weeks later), and at the end of the rehabilitation program. A retention test was also programed after 6 weeks. RESULTS While there was no additional effect of MI on pain management, data revealed an early positive impact of MI for the 10 m walking task during the pre-prosthetic phase, and greater performance during the Timed Up and Go Test during the prosthetic phase. Also, a lower proportion of participants still needed a walking aid after MI training. Finally, the force of the amputated limb was greater at the end of rehabilitation for the MI group. CONCLUSION Taken together, these data support the integration of MI within the course of physical therapy in persons suffering from lower-limb amputations.
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Affiliation(s)
- Elodie Saruco
- Universite Lyon 1, LIBM, Laboratoire Interuniversitaire de Biologie de la Motricité, UR 7424, Villeurbanne, F-69622, France
| | - Arnaud Saimpont
- Universite Lyon 1, LIBM, Laboratoire Interuniversitaire de Biologie de la Motricité, UR 7424, Villeurbanne, F-69622, France
| | - Franck Di Rienzo
- Universite Lyon 1, LIBM, Laboratoire Interuniversitaire de Biologie de la Motricité, UR 7424, Villeurbanne, F-69622, France
| | - Benjamin De Witte
- Universite Lyon 1, LIBM, Laboratoire Interuniversitaire de Biologie de la Motricité, UR 7424, Villeurbanne, F-69622, France
| | - Isabelle Laroyenne
- Centre Médico-Chirurgical de Réadaptation des Massues - Croix-Rouge française, 92 rue Dr. Edmond Locard, Lyon Cedex 05, 69322, France
| | - Fanny Matéo
- Centre Médico-Chirurgical de Réadaptation des Massues - Croix-Rouge française, 92 rue Dr. Edmond Locard, Lyon Cedex 05, 69322, France
| | - Marion Lapenderie
- Centre Médico-Chirurgical de Réadaptation des Massues - Croix-Rouge française, 92 rue Dr. Edmond Locard, Lyon Cedex 05, 69322, France
| | - Sarah Goutte Solard
- Centre Médico-Chirurgical de Réadaptation des Massues - Croix-Rouge française, 92 rue Dr. Edmond Locard, Lyon Cedex 05, 69322, France
| | - Isabelle Perretant
- Centre Médico-Chirurgical de Réadaptation des Massues - Croix-Rouge française, 92 rue Dr. Edmond Locard, Lyon Cedex 05, 69322, France
| | - Charlotte Frenot
- Centre Médico-Chirurgical de Réadaptation des Massues - Croix-Rouge française, 92 rue Dr. Edmond Locard, Lyon Cedex 05, 69322, France
| | - Philip L Jackson
- École de Psychologie, Université Laval, Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale (CIRRIS), Quebec, Canada
| | - Aymeric Guillot
- Universite Lyon 1, LIBM, Laboratoire Interuniversitaire de Biologie de la Motricité, UR 7424, Villeurbanne, F-69622, France.
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Woodrow-Hill C, Gowen E, Vogt S, Edmonds E, Poliakoff E. Stimulus specificity in combined action observation and motor imagery of typing. Q J Exp Psychol (Hove) 2024:17470218241241502. [PMID: 38482583 DOI: 10.1177/17470218241241502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
Combined action observation and motor imagery (AO + MI) can improve movement execution (ME) in healthy adults and certain patient populations. However, it is unclear how the specificity of the observation component during AO + MI influences ME. As generalised observation could result in more flexible AO + MI rehabilitation programmes, this study investigated whether observing typing of target words (specific condition) or non-matching words (general condition) during AO + MI would have different effects on keyboard typing in healthy young adults. In Experiment 1, 51 students imagined typing a target word while watching typing videos that were either specific to the target word or general. There were no differences in typing execution between AO + MI conditions, though participants typed more slowly after both AO + MI conditions compared with no observation or imagery. Experiment 2 repeated Experiment 1 in 20 students, but with a faster stimulus speed in the AO + MI conditions and increased cognitive difficulty in the control condition. The results showed that the slowed typing after AO + MI was likely due to a strong influence of task-switching between imagery and execution, as well as an automatic imitation effect. Both experiments demonstrate that general and specific AO + MI comparably affect ME. In addition, slower ME following both AO + MI and a challenging cognitive task provides support for the motor-cognitive model of MI.
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Affiliation(s)
- Camilla Woodrow-Hill
- Division of Psychology, Communication and Human Neuroscience, The University of Manchester, Manchester, UK
| | - Emma Gowen
- Division of Psychology, Communication and Human Neuroscience, The University of Manchester, Manchester, UK
| | - Stefan Vogt
- Psychology Department, Lancaster University, Lancaster, UK
| | - Eve Edmonds
- Division of Psychology, Communication and Human Neuroscience, The University of Manchester, Manchester, UK
| | - Ellen Poliakoff
- Division of Psychology, Communication and Human Neuroscience, The University of Manchester, Manchester, UK
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Gowen E, Edmonds E, Poliakoff E. Motor imagery in autism: a systematic review. Front Integr Neurosci 2024; 18:1335694. [PMID: 38410719 PMCID: PMC10895877 DOI: 10.3389/fnint.2024.1335694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 01/17/2024] [Indexed: 02/28/2024] Open
Abstract
Introduction Motor Imagery (MI) is when an individual imagines performing an action without physically executing that action and is thought to involve similar neural processes used for execution of physical movement. As motor coordination difficulties are common in autistic individuals it is possible that these may affect MI ability. The aim of this systematic review was to assess the current knowledge around MI ability in autistic individuals. Methods A systematic search was conducted for articles published before September 2023, following PRISMA guidance. Search engines were PsycINFO, PubMed, Web of Science, Scopus, Wiley Online Library and PsyArXiv. Inclusion criteria included: (a) Original peer-reviewed and pre-print publications; (b) Autistic and a non-autistic group (c) Implicit or explicit imagery tasks (d) Behavioral, neurophysiological or self-rating measures, (e) Written in the English language. Exclusion criteria were (a) Articles only about MI or autism (b) Articles where the autism data is not presented separately (c) Articles on action observation, recognition or imitation only (d) Review articles. A narrative synthesis of the evidence was conducted. Results Sixteen studies across fourteen articles were included. Tasks were divided into implicit (unconscious) or explicit (conscious) MI. The implicit tasks used either hand (6) or body (4) rotation tasks. Explicit tasks consisted of perspective taking tasks (3), a questionnaire (1) and explicit instructions to imagine performing a movement (2). A MI strategy was apparent for the hand rotation task in autistic children, although may have been more challenging. Evidence was mixed and inconclusive for the remaining task types due to the varied range of different tasks and, measures conducted and design limitations. Further limitations included a sex bias toward males and the hand rotation task only being conducted in children. Discussion There is currently an incomplete understanding of MI ability in autistic individuals. The field would benefit from a battery of fully described implicit and explicit MI tasks, conducted across the same groups of autistic children and adults. Improved knowledge around MI in autistic individuals is important for understanding whether MI techniques may benefit motor coordination in some autistic people.
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Affiliation(s)
- Emma Gowen
- Division of Psychology, Communication and Human Neuroscience, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
| | - Eve Edmonds
- Division of Psychology, Communication and Human Neuroscience, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
| | - Ellen Poliakoff
- Division of Psychology, Communication and Human Neuroscience, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
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Mezzarobba S, Bonassi G, Avanzino L, Pelosin E. Action Observation and Motor Imagery as a Treatment in Patients with Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2024:JPD230219. [PMID: 38250785 DOI: 10.3233/jpd-230219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
Action observation (AO) and motor imagery (MI) has emerged as promising tool for physiotherapy intervention in Parkinson's disease (PD). This narrative review summarizes why, how, and when applying AO and MI training in individual with PD. We report the neural underpinning of AO and MI and their effects on motor learning. We examine the characteristics and the current evidence regarding the effectiveness of physiotherapy interventions and we provide suggestions about their implementation with technologies. Neurophysiological data suggest a substantial correct activation of brain networks underlying AO and MI in people with PD, although the occurrence of compensatory mechanisms has been documented. Regarding the efficacy of training, in general evidence indicates that both these techniques improve mobility and functional activities in PD. However, these findings should be interpreted with caution due to variety of the study designs, training characteristics, and the modalities in which AO and MI were applied. Finally, results on long-term effects are still uncertain. Several elements should be considered to optimize the use of AO and MI in clinical setting, such as the selection of the task, the imagery or the video perspectives, the modalities of training. However, a comprehensive individual assessment, including motor and cognitive abilities, is essential to select which between AO and MI suite the best to each PD patients. Much unrealized potential exists for the use AO and MI training to provide personalized intervention aimed at fostering motor learning in both the clinic and home setting.
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Affiliation(s)
- Susanna Mezzarobba
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, and "RAISE Ecosystem", Genova, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Gaia Bonassi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, and "RAISE Ecosystem", Genova, Italy
| | - Laura Avanzino
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Experimental Medicine, Section of Human Physiology, University of Genoa, Genoa, Italy
| | - Elisa Pelosin
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, and "RAISE Ecosystem", Genova, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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Ferreira-Sánchez MDR, Moreno-Verdú M, Poliakoff E, Sánchez Milá Z, Rodríguez Sanz D, Frutos Llanes R, Barragán Casas JM, Velázquez Saornil J. Differences in Motor Imagery Ability between People with Parkinson's Disease and Healthy Controls, and Its Relationship with Functionality, Independence and Quality of Life. Healthcare (Basel) 2023; 11:2898. [PMID: 37958042 PMCID: PMC10650523 DOI: 10.3390/healthcare11212898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/24/2023] [Accepted: 11/02/2023] [Indexed: 11/15/2023] Open
Abstract
Motor imagery (MI) has been shown to be effective for the acquisition of motor skills; however, it is still unknown whether similar benefits can be achieved in neurological patients. Previous findings of differences in MI ability between people with Parkinson's disease (PwPD) and healthy controls (HCs) are mixed. This study examined differences in the ability to both create and maintain MI as well as investigating the relationship between the ability to create and maintain MI and motor function, independence and quality of life (QoL). A case-control study was conducted (31 PwPD and 31 HCs), collecting gender, age, dominance, socio-demographic data, duration and impact of the disease. MI intensity (MIQ-RS and KVIQ-34) and temporal accuracy of MI (imagined box and block test [iBBT], imagined timed stand and walk test [iTUG]) were assessed. Functional and clinical assessments included upper limb motor function, balance, gait, independence in activities of daily living and quality of life measures. Statistically significant differences in temporal accuracy were observed and partial and weak relationships were revealed between MI measures and functioning, independence and QoL. PwPD retain the ability to create MI, indicating the suitability of MI in this population. Temporal accuracy might be altered as a reflection of bradykinesia on the mentally simulated actions.
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Affiliation(s)
- María del Rosario Ferreira-Sánchez
- NEUMUSK Group, Facultad de Ciencias de la Salud, Universidad Católica de Ávila, C/Canteros s/n, 05005 Ávila, Spain; (M.d.R.F.-S.); (R.F.L.); (J.M.B.C.); (J.V.S.)
| | - Marcos Moreno-Verdú
- Brain, Action and Skill Laboratory, Institute of Neuroscience (Cognition and Systems Division), UC Louvain, 1348 Ottignies-Louvain-la-Neuve, Belgium;
| | - Ellen Poliakoff
- Body Eyes and Movement (BEAM) Laboratory, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK;
| | - Zacarías Sánchez Milá
- NEUMUSK Group, Facultad de Ciencias de la Salud, Universidad Católica de Ávila, C/Canteros s/n, 05005 Ávila, Spain; (M.d.R.F.-S.); (R.F.L.); (J.M.B.C.); (J.V.S.)
| | - David Rodríguez Sanz
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain;
| | - Raúl Frutos Llanes
- NEUMUSK Group, Facultad de Ciencias de la Salud, Universidad Católica de Ávila, C/Canteros s/n, 05005 Ávila, Spain; (M.d.R.F.-S.); (R.F.L.); (J.M.B.C.); (J.V.S.)
| | - José Manuel Barragán Casas
- NEUMUSK Group, Facultad de Ciencias de la Salud, Universidad Católica de Ávila, C/Canteros s/n, 05005 Ávila, Spain; (M.d.R.F.-S.); (R.F.L.); (J.M.B.C.); (J.V.S.)
| | - Jorge Velázquez Saornil
- NEUMUSK Group, Facultad de Ciencias de la Salud, Universidad Católica de Ávila, C/Canteros s/n, 05005 Ávila, Spain; (M.d.R.F.-S.); (R.F.L.); (J.M.B.C.); (J.V.S.)
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Huang Y, Zheng J, Xu B, Li X, Liu Y, Wang Z, Feng H, Cao S. An improved model using convolutional sliding window-attention network for motor imagery EEG classification. Front Neurosci 2023; 17:1204385. [PMID: 37662108 PMCID: PMC10469504 DOI: 10.3389/fnins.2023.1204385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 07/26/2023] [Indexed: 09/05/2023] Open
Abstract
Introduction The classification model of motor imagery-based electroencephalogram (MI-EEG) is a new human-computer interface pattern and a new neural rehabilitation assessment method for diseases such as Parkinson's and stroke. However, existing MI-EEG models often suffer from insufficient richness of spatiotemporal feature extraction, learning ability, and dynamic selection ability. Methods To solve these problems, this work proposed a convolutional sliding window-attention network (CSANet) model composed of novel spatiotemporal convolution, sliding window, and two-stage attention blocks. Results The model outperformed existing state-of-the-art (SOTA) models in within- and between-individual classification tasks on commonly used MI-EEG datasets BCI-2a and Physionet MI-EEG, with classification accuracies improved by 4.22 and 2.02%, respectively. Discussion The experimental results also demonstrated that the proposed type token, sliding window, and local and global multi-head self-attention mechanisms can significantly improve the model's ability to construct, learn, and adaptively select multi-scale spatiotemporal features in MI-EEG signals, and accurately identify electroencephalogram signals in the unilateral motor area. This work provided a novel and accurate classification model for MI-EEG brain-computer interface tasks and proposed a feasible neural rehabilitation assessment scheme based on the model, which could promote the further development and application of MI-EEG methods in neural rehabilitation.
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Affiliation(s)
- Yuxuan Huang
- School of Computer Science and Technology, Donghua University, Shanghai, China
| | - Jianxu Zheng
- Department of Neurosurgery and State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Binxing Xu
- School of Computer Science and Technology, Donghua University, Shanghai, China
| | - Xuhang Li
- School of Computer Science and Technology, Donghua University, Shanghai, China
| | - Yu Liu
- School of Computer Science and Technology, Donghua University, Shanghai, China
| | - Zijian Wang
- School of Computer Science and Technology, Donghua University, Shanghai, China
| | - Hua Feng
- Department of Neurosurgery and State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Shiqi Cao
- Department of Orthopaedics of TCM Clinical Unit, The Sixth Medical Center, Chinese PLA General Hospital, Beijing, China
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Cherry J, Kamel S, Elfil M, Aravala SS, Bayoumi A, Patel A, Sinha R, Tinaz S. Mental imagery content is associated with disease severity and specific brain functional connectivity changes in patients with Parkinson's disease. Brain Imaging Behav 2023; 17:161-171. [PMID: 36434490 PMCID: PMC10050121 DOI: 10.1007/s11682-022-00749-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2022] [Indexed: 11/27/2022]
Abstract
Mental imagery is the mental re-creation of perceptual experiences, events and scenarios, and motor acts. In our previous study, we assessed whether motor imagery (MI) training combined with functional magnetic resonance imaging-based neurofeedback could improve the motor function of nondemented subjects with mild Parkinson's disease (PD) (N = 22). We used visual imagery (VI) (e.g., of scenes or events, but not of self-movements) training without neurofeedback for the control group (N = 22). Notably, both groups showed significant and comparable improvement in motor function after four weeks of daily imagery practice. In this study, we further examined the neural correlates of the motor enhancement as a result of the VI training by analyzing the self-reported VI content during daily practice and relating its quality to the functional connectivity characteristics of the same subjects. We demonstrated that the VI practice encompassed multisensory, spatial, affective, and executive processes all of which are also important for motor function in real life. Subjects with worse global disease severity also showed poorer quality of the VI content. Finally, the quality of the VI content showed significant positive correlations with the functional connectivity changes during the VI tasks in brain areas supporting visuospatial and sensorimotor processes. Our findings suggest that mental imagery training combining VI and MI may enhance motor function in patients with mild PD, and more broadly, underline the importance of incorporating self-reports of thoughts and experiences in neuroimaging studies that examine the brain mechanisms of complex cognitive processes especially in neuropsychiatric patient populations.
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Affiliation(s)
- Jared Cherry
- Department of Neurology, Division of Movement Disorders, Yale University School of Medicine, New Haven, CT, USA
- Clinical Neurosciences Imaging Center, Yale University School of Medicine, New Haven, CT, USA
| | - Serageldin Kamel
- Department of Neurology, Division of Movement Disorders, Yale University School of Medicine, New Haven, CT, USA
- Clinical Neurosciences Imaging Center, Yale University School of Medicine, New Haven, CT, USA
| | - Mohamed Elfil
- Department of Neurology, Division of Movement Disorders, Yale University School of Medicine, New Haven, CT, USA
- Clinical Neurosciences Imaging Center, Yale University School of Medicine, New Haven, CT, USA
| | - Sai S Aravala
- Department of Neurology, Division of Movement Disorders, Yale University School of Medicine, New Haven, CT, USA
- Clinical Neurosciences Imaging Center, Yale University School of Medicine, New Haven, CT, USA
| | - Ahmed Bayoumi
- Department of Neurology, Division of Movement Disorders, Yale University School of Medicine, New Haven, CT, USA
- Clinical Neurosciences Imaging Center, Yale University School of Medicine, New Haven, CT, USA
| | - Amar Patel
- Department of Neurology, Division of Movement Disorders, Yale University School of Medicine, New Haven, CT, USA
| | - Rajita Sinha
- Yale Stress Center, Yale University School of Medicine, New Haven, CT, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT, USA
| | - Sule Tinaz
- Department of Neurology, Division of Movement Disorders, Yale University School of Medicine, New Haven, CT, USA.
- Clinical Neurosciences Imaging Center, Yale University School of Medicine, New Haven, CT, USA.
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11
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Readman MR, Crawford TJ, Linkenauger SA, Bek J, Poliakoff E. Motor imagery vividness and symptom severity in Parkinson's disease. J Neuropsychol 2023; 17:180-192. [PMID: 36229225 PMCID: PMC10946738 DOI: 10.1111/jnp.12293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 09/12/2022] [Accepted: 09/13/2022] [Indexed: 11/28/2022]
Abstract
Motor imagery (MI), the mental simulation of movement in the absence of overt motor output, has demonstrated potential as a technique to support rehabilitation of movement in neurological conditions such as Parkinson's disease (PD). Existing evidence suggests that MI is largely preserved in PD, but previous studies have typically examined global measures of MI and have not considered the potential impact of individual differences in symptom presentation on MI. The present study investigated the influence of severity of overall motor symptoms, bradykinesia and tremor on MI vividness scores in 44 individuals with mild to moderate idiopathic PD. Linear mixed effects modelling revealed that imagery modality and the severity of left side bradykinesia significantly influenced MI vividness ratings. Consistent with previous findings, participants rated visual motor imagery (VMI) to be more vivid than kinesthetic motor imagery (KMI). Greater severity of left side bradykinesia (but not right side bradykinesia) predicted increased vividness of KMI, while tremor severity and overall motor symptom severity did not predict vividness of MI. The specificity of the effect of bradykinesia to the left side may reflect greater premorbid vividness for the dominant (right) side or increased attention to more effortful movements on the left side of the body resulting in more vivid motor imagery.
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Affiliation(s)
| | | | | | - Judith Bek
- Centre for Motor Control, Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, ON, Canada
- Division of Psychology, Communication and Human Neuroscience, School of Health Sciences., University of Manchester, Manchester, UK
| | - Ellen Poliakoff
- Division of Psychology, Communication and Human Neuroscience, School of Health Sciences., University of Manchester, Manchester, UK
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12
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Li Y, Zheng JJ, Wu X, Gao W, Liu CJ. Postural control of Parkinson's disease: A visualized analysis based on Citespace knowledge graph. Front Aging Neurosci 2023; 15:1136177. [PMID: 37032828 PMCID: PMC10080997 DOI: 10.3389/fnagi.2023.1136177] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 03/02/2023] [Indexed: 04/11/2023] Open
Abstract
Postural control impairment is one of the primary motor symptoms in patients with Parkinson's disease, leading to an increased risk of falling. Several studies have been conducted on postural control disorders in Parkinson's disease patients, but no relevant bibliometric analysis has been found. In this paper, the Web of Science Core Collection database was searched for 1,295 relevant papers on postural control in Parkinson's disease patients from December 2011 to December 2021. Based on the Citespace knowledge graph, these relevant papers over the last decade were analyzed from the perspectives of annual publication volume, countries and institutes cooperation, authors cooperation, dual-map overlay of journals, co-citation literature, and keywords. The purpose of this study was to explore the current research status, research hotspots, and frontiers in this field, and to provide a reference for further promoting the research on postural control in Parkinson's disease patients.
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Affiliation(s)
- Yan Li
- Department of Rehabilitation Medicine, Huadong Hospital, Fudan University, Shanghai, China
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Jie-Jiao Zheng
- Department of Rehabilitation Medicine, Huadong Hospital, Fudan University, Shanghai, China
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- Shanghai Clinical Research Center for Rehabilitation Medicine, Shanghai, China
- *Correspondence: Jie-Jiao Zheng,
| | - Xie Wu
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Wen Gao
- Department of Rehabilitation Medicine, Huadong Hospital, Fudan University, Shanghai, China
- Shanghai Clinical Research Center for Rehabilitation Medicine, Shanghai, China
| | - Chan-Jing Liu
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
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13
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Test-Retest Reliability and Criterion Validity of the Spanish Version of Two Motor Imagery Questionnaires in People With Parkinson Disease. J Neurol Phys Ther 2023; 47:35-43. [PMID: 36534018 DOI: 10.1097/npt.0000000000000416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND PURPOSE The Kinesthetic and Visual Imagery Questionnaire (KVIQ) and the Movement Imagery Questionnaire-Revised Second Version (MIQ-RS) are measurement instruments that assess motor imagery vividness. The aim of this study was to examine the validity and reliability of the Spanish KVIQ and MIQ-RS in people with Parkinson disease (PD). METHODS A longitudinal descriptive study was conducted following the COSMIN standards. Thirty-five people with idiopathic PD were evaluated twice (7-15 days apart) with the Spanish KVIQ and MIQ-RS. Structural validity, internal consistency, test-retest reliability (ICC), standard error of measurement (SEM), smallest detectable change (SDC), and criterion validity of the MIQ-RS and KVIQ long (KVIQ-20), short (KVIQ-10), and extended (KVIQ-34) versions and their subscales (if pertinent) were tested. RESULTS Factor analysis was satisfactory for the MIQ-RS, KVIQ-20, and KVIQ-10, providing evidence of their 2-dimensional structure. Evidence of the structural validity of the KVIQ-34 was not confirmed and thus was analyzed as an overall score. Revelle's ω > 0.9 showed excellent internal consistency. Test-retest reliability was moderate (ICC = 0.58-0.75) and higher for all visual subscales. SEM and SDC were up to 14.39% and 39.89% of the scores, respectively. Criterion validity between questionnaires and subscales was strong (Spearman's r > 0.7). DISCUSSION AND CONCLUSIONS The results provide evidence for the validity and reliability of the Spanish MIQ-RS, KVIQ-20, and KVIQ-10 to assess motor imagery vividness in people with PD, whereas the KVIQ-34 should only be interpreted as an overall score. Psychometric, procedural, and practical features of the questionnaires should be considered when applying into clinical practice.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A401).
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14
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Sawai S, Murata S, Fujikawa S, Yamamoto R, Shima K, Nakano H. Effects of neurofeedback training combined with transcranial direct current stimulation on motor imagery: A randomized controlled trial. Front Neurosci 2023; 17:1148336. [PMID: 36937688 PMCID: PMC10017549 DOI: 10.3389/fnins.2023.1148336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 02/16/2023] [Indexed: 03/06/2023] Open
Abstract
Introduction Neurofeedback (NFB) training and transcranial direct current stimulation (tDCS) have been shown to individually improve motor imagery (MI) abilities. However, the effect of combining both of them with MI has not been verified. Therefore, the aim of this study was to examine the effect of applying tDCS directly before MI with NFB. Methods Participants were divided into an NFB group (n = 10) that performed MI with NFB and an NFB + tDCS group (n = 10) that received tDCS for 10 min before MI with NFB. Both groups performed 60 MI trials with NFB. The MI task was performed 20 times without NFB before and after training, and μ-event-related desynchronization (ERD) and vividness MI were evaluated. Results μ-ERD increased significantly in the NFB + tDCS group compared to the NFB group. MI vividness significantly increased before and after training. Discussion Transcranial direct current stimulation and NFB modulate different processes with respect to MI ability improvement; hence, their combination might further improve MI performance. The results of this study indicate that the combination of NFB and tDCS for MI is more effective in improving MI abilities than applying them individually.
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Affiliation(s)
- Shun Sawai
- Graduate School of Health Sciences, Kyoto Tachibana University, Kyoto, Japan
- Department of Rehabilitation, Kyoto Kuno Hospital, Kyoto, Japan
| | - Shin Murata
- Graduate School of Health Sciences, Kyoto Tachibana University, Kyoto, Japan
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto, Japan
| | - Shoya Fujikawa
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto, Japan
| | - Ryosuke Yamamoto
- Department of Rehabilitation, Tesseikai Neurosurgical Hospital, Shijonawate, Japan
| | - Keisuke Shima
- Graduate School of Environment and Information Sciences, Yokohama National University, Yokohama, Japan
| | - Hideki Nakano
- Graduate School of Health Sciences, Kyoto Tachibana University, Kyoto, Japan
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto, Japan
- *Correspondence: Hideki Nakano,
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15
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Eaves DL, Hodges NJ, Buckingham G, Buccino G, Vogt S. Enhancing motor imagery practice using synchronous action observation. PSYCHOLOGICAL RESEARCH 2022:10.1007/s00426-022-01768-7. [PMID: 36574019 DOI: 10.1007/s00426-022-01768-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 11/07/2022] [Indexed: 12/28/2022]
Abstract
In this paper, we discuss a variety of ways in which practising motor actions by means of motor imagery (MI) can be enhanced via synchronous action observation (AO), that is, by AO + MI. We review the available research on the (mostly facilitatory) behavioural effects of AO + MI practice in the early stages of skill acquisition, discuss possible theoretical explanations, and consider several issues related to the choice and presentation schedules of suitable models. We then discuss considerations related to AO + MI practice at advanced skill levels, including expertise effects, practical recommendations such as focussing attention on specific aspects of the observed action, using just-ahead models, and possible effects of the perspective in which the observed action is presented. In section "Coordinative AO + MI", we consider scenarios where the observer imagines performing an action that complements or responds to the observed action, as a promising and yet under-researched application of AO + MI training. In section "The dual action simulation hypothesis of AO + MI", we review the neurocognitive hypothesis that AO + MI practice involves two parallel action simulations, and we consider opportunities for future research based on recent neuroimaging work on parallel motor representations. In section "AO + MI training in motor rehabilitation", we review applications of AO, MI, and AO + MI training in the field of neurorehabilitation. Taken together, this evidence-based, exploratory review opens a variety of avenues for future research and applications of AO + MI practice, highlighting several clear advantages over the approaches of purely AO- or MI-based practice.
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Affiliation(s)
- Daniel L Eaves
- School of Biomedical, Nutritional and Sport Sciences, Newcastle University, Newcastle upon Tyne, UK.
| | - Nicola J Hodges
- School of Kinesiology, University of British Columbia, Vancouver, Canada
| | - Gavin Buckingham
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Giovanni Buccino
- Division of Neuroscience, IRCCS San Raffaele and Vita Salute San Raffaele University, Milan, Italy
| | - Stefan Vogt
- Department of Psychology, Lancaster University, Lancaster, UK.
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16
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Moon K, Lee M, Han K. Effects of
3D
virtual reality motionless imagery training program with an avatar. Psych J 2022; 12:169-177. [PMID: 36336337 DOI: 10.1002/pchj.614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 09/09/2022] [Indexed: 11/09/2022]
Abstract
The present study aimed to explore the effects of motionless imagery training with an avatar in virtual reality (VR) on emotion, cognition, and physiological response changes in healthy adults. Participants were 30 healthy adults aged between 19 and 35 years. All participants were randomly divided into the experimental group (n = 18), which executed the imagery training with an avatar in VR, or the control group (n = 12), which merely experienced the VR without an avatar. Both groups underwent the intervention, a 20-min session, 3 times a week for 6 weeks. VR experience questionnaires and physiological response changes were measured at pre- and post-test and emotional states and cognition tests were measured at pre-, post-, and follow-up test. The experimental group showed no significant changes in the Presence Questionnaire (PQ) and the Simulator Sickness Questionnaire (SSQ) after the intervention while the control group showed a significant decrease in the PQ after the intervention. In all emotional states, there were no significant differences in the interaction between times and groups. A significant main effect of time was revealed in all cognition tests except the delayed recall and the delayed recognition in K-Auditory Verbal Learning Test (K-AVLT). In physiological response changes, the experimental group showed significant improvements in the electromyogram (EMG) at rectus femoris on the left side after the intervention. Thus, imagery training with an avatar in VR can be considered to be effective for enhancements of cognitions and physiological response changes.
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Affiliation(s)
- Kyung‐Ji Moon
- Division of Sport Science Pusan National University Busan Republic of Korea
| | - Myung‐Chul Lee
- Division of Sport Science Pusan National University Busan Republic of Korea
| | - Kyung‐Hun Han
- Division of Sport Science Pusan National University Busan Republic of Korea
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17
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Rizzi B, Nuresi C, Rovacchi C, Bacchini M, Savi F, Falco L, Schianchi L, Scaglioni A, Ciracì C, Costantino C, Buccino G. Motor imagery and action-observation in neurorehabilitation: A study protocol in Parkinson's disease patients. Front Neurol 2022; 13:990618. [PMID: 36267882 PMCID: PMC9577192 DOI: 10.3389/fneur.2022.990618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 09/15/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionAction Observation Treatment (AOT) and Motor Imagery (MI) represent very promising cognitive strategies in neuro-rehabilitation. This study aims to compare the effectiveness of the two cognitive strategies, taken alone or combined, in Parkinson's disease patients.Material and methodsThis study is designed as a prospective randomized controlled trial, with four arms. We estimated a sample size of 64 patients (16 in each treatment group) to be able to detect an effect size of F = 0.4 with a statistical significance of 0.05. Primary outcomes will be functional gains in the FIM and UPDRS scales. Secondary outcome measure will be functional gain as revealed by kinematic parameters measured at Gait Analysis.DiscussionThe results of this trial will provide insights into the use of AOT and MI, taken alone or combined, in the rehabilitation of Parkinson's disease patients.Ethics and disseminationThe study protocol was approved by the Ethics Committee of the Don Gnocchi Foundation. The study will be conducted in accordance with the 1996 World Medical Association guidelines and according to good clinical practice. The study has been registered on clinicaltrial.gov under the following code: AOTPRFDG. Dissemination will include both submission of the study to peer-reviewed journals and discussion of the study protocol at conferences.
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Affiliation(s)
- Beatrice Rizzi
- Department of Neuromotor Rehabilitation, Santa Maria ai Servi Center, Don Carlo Gnocchi Foundation ONLUS, Parma, Italy
| | - Christian Nuresi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Claudio Rovacchi
- Department of Neuromotor Rehabilitation, Santa Maria ai Servi Center, Don Carlo Gnocchi Foundation ONLUS, Parma, Italy
| | - Massimo Bacchini
- Department of Neuromotor Rehabilitation, Santa Maria ai Servi Center, Don Carlo Gnocchi Foundation ONLUS, Parma, Italy
| | - Federica Savi
- Department of Neuromotor Rehabilitation, Santa Maria ai Servi Center, Don Carlo Gnocchi Foundation ONLUS, Parma, Italy
| | - Lucia Falco
- Department of Neuromotor Rehabilitation, Santa Maria ai Servi Center, Don Carlo Gnocchi Foundation ONLUS, Parma, Italy
| | - Luca Schianchi
- Department of Neuromotor Rehabilitation, Santa Maria ai Servi Center, Don Carlo Gnocchi Foundation ONLUS, Parma, Italy
| | - Augusto Scaglioni
- Department of Neuromotor Rehabilitation, Santa Maria ai Servi Center, Don Carlo Gnocchi Foundation ONLUS, Parma, Italy
| | - Chiara Ciracì
- Department of Neuromotor Rehabilitation, Santa Maria ai Servi Center, Don Carlo Gnocchi Foundation ONLUS, Parma, Italy
| | - Cosimo Costantino
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Giovanni Buccino
- Division of Neuroscience, Università Vita-Salute San Raffaele, Milan, Italy
- IRCCS San Raffaele, Milan, Italy
- *Correspondence: Giovanni Buccino
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18
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Bezerra PT, Santiago LM, Silva IA, Souza AA, Pegado CL, Damascena CM, Ribeiro TS, Lindquist AR. Action observation and motor imagery have no effect on balance and freezing of gait in Parkinson's disease: a randomized controlled trial. Eur J Phys Rehabil Med 2022; 58:715-722. [PMID: 36052889 PMCID: PMC10019482 DOI: 10.23736/s1973-9087.22.07313-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Combining action observation (AO) and motor imagery (MI) training may induce greater brain activity in areas usually involved in Parkinson's disease (PD) and lead to greater behavioral and neurophysiological effects than when used separately. AIM To determine the effects of combining AO, MI, and gait training on balance and freezing of gait in individuals with PD. DESIGN This is a single-blinded, randomized controlled clinical trial. SETTING Laboratory of Intervention and Analysis of Movement (LIAM) from the Department of Physical Therapy of a Brazilian University. POPULATION Study sample consisted of individuals diagnosed with idiopathic PD by a neurologist specialized in movement disorders. METHODS 39 individuals with PD were divided into experimental (EG=21) and control groups (CG=18). EG performed 12 sessions of AO, MI, and gait training, whereas CG watched PD-related educational videos and performed 12 sessions of gait training. Balance (measured using the Mini Balance Evaluation Systems Test [MiniBESTest]) and freezing of gait (measured using the Freezing of Gait Questionnaire) were reassessed one day after the end of the intervention. RESULTS We did not observe significant intra- and intergroup differences in freezing of gait. For the EG, we observed a significant intragroup difference in the total score of MiniBESTest (F=5.2; P=0.02), and sensory orientation (F=4.5; P=0.04) and dynamic gait (F=3.6; P=0.03) domains. MiniBESTest domains were not different between groups. CONCLUSIONS Combining AO, MI, and gait training was not more effective than isolated gait training for balance and freezing of gait in individuals with PD. CLINICAL REHABILITATION IMPACT MI training can moderate AO effects and enhance motor learning when both therapies are combined. Therefore, this approach may still have the potential to be included in the treatment of PD. New studies should investigate whether the factors that influence these results are related to the protocol's sensitivity in changing the evaluated parameters or to the time and intensity of AO and MI training.
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Affiliation(s)
- Paula T Bezerra
- Department of Physical Therapy, Rio Grande do Norte Federal University, Natal, Rio Grande do Norte, Brazil
| | - Lorenna M Santiago
- Department of Physical Therapy, Rio Grande do Norte Federal University, Natal, Rio Grande do Norte, Brazil.,Anita Garibaldi Education and Health Research Center, Santos Dumont Institute, Macaíba, Rio Grande do Norte, Brazil
| | - Isaíra A Silva
- Department of Physical Therapy, Rio Grande do Norte Federal University, Natal, Rio Grande do Norte, Brazil
| | - Aline A Souza
- Department of Physical Therapy, Rio Grande do Norte Federal University, Natal, Rio Grande do Norte, Brazil
| | - Camila L Pegado
- Department of Physical Therapy, Rio Grande do Norte Federal University, Natal, Rio Grande do Norte, Brazil
| | - Clécia M Damascena
- University of Estácio do Rio Grande do Norte (Fatern), Natal, Rio Grande do Norte, Brazil
| | - Tatiana S Ribeiro
- Department of Physical Therapy, Rio Grande do Norte Federal University, Natal, Rio Grande do Norte, Brazil
| | - Ana R Lindquist
- Department of Physical Therapy, Rio Grande do Norte Federal University, Natal, Rio Grande do Norte, Brazil -
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Tinaz S, Kamel S, Aravala SS, Elfil M, Bayoumi A, Patel A, Scheinost D, Sinha R, Hampson M. Neurofeedback-guided kinesthetic motor imagery training in Parkinson's disease: Randomized trial. Neuroimage Clin 2022; 34:102980. [PMID: 35247729 PMCID: PMC8897714 DOI: 10.1016/j.nicl.2022.102980] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 01/23/2022] [Accepted: 02/28/2022] [Indexed: 11/06/2022]
Abstract
Parkinson’s disease causes difficulty with sustained motor performance. Insula and dorsomedial frontal cortex (dmFC) are implicated in motivating movement. Regulation of insula-dmFC functional connectivity with neurofeedback (NF) failed. Motor imagery practice regardless of NF improved motor function and body awareness. Visual imagery practice without NF also improved motor function.
Background Parkinson’s disease (PD) causes difficulty with maintaining the speed, size, and vigor of movements, especially when they are internally generated. We previously proposed that the insula is important in motivating intentional movement via its connections with the dorsomedial frontal cortex (dmFC). We demonstrated that subjects with PD can increase the right insula-dmFC functional connectivity using fMRI-based neurofeedback (NF) combined with kinesthetic motor imagery (MI). The current study is a randomized clinical trial testing whether NF-guided kinesthetic MI training can improve motor performance and increase task-based and resting-state right insula-dmFC functional connectivity in subjects with PD. Methods We assigned nondemented subjects with mild PD (Hoehn & Yahr stage ≤ 3) to the experimental kinesthetic MI with NF (MI-NF, n = 22) and active control visual imagery (VI, n = 22) groups. Only the MI-NF group received NF-guided MI training (10–12 runs). The NF signal was based on the right insula-dmFC functional connectivity strength. All subjects also practiced their respective imagery tasks at home daily for 4 weeks. Post-training changes in 1) task-based and resting-state right insula-dmFC functional connectivity were the primary imaging outcomes, and 2) MDS-UPDRS motor exam and motor function scores were the primary and secondary clinical outcomes, respectively. Results The MI-NF group was not significantly different from the VI group in any of the primary imaging or clinical outcome measures. The MI-NF group reported subjective improvement in kinesthetic body awareness. There was significant and comparable improvement only in motor function scores in both groups (secondary clinical outcome). This improvement correlated with NF regulation of the right insula-dmFC functional connectivity only in the MI-NF group. Both groups showed specific training effects in whole-brain functional connectivity with distinct neural circuits supporting kinesthetic motor and visual imagery (exploratory imaging outcome). Conclusions The functional connectivity-based NF regulation was unsuccessful, however, both kinesthetic MI and VI practice improved motor function in our cohort with mild PD.
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Affiliation(s)
- Sule Tinaz
- Yale School of Medicine, Department of Neurology, Division of Movement Disorders, 15 York St, LCI 710, New Haven, CT 06510, USA; Yale School of Medicine, Clinical Neuroscience Imaging Center, 789 Howard Ave, New Haven, CT 06519, USA.
| | - Serageldin Kamel
- Yale School of Medicine, Department of Neurology, Division of Movement Disorders, 15 York St, LCI 710, New Haven, CT 06510, USA; Yale School of Medicine, Clinical Neuroscience Imaging Center, 789 Howard Ave, New Haven, CT 06519, USA
| | - Sai S Aravala
- Yale School of Medicine, Department of Neurology, Division of Movement Disorders, 15 York St, LCI 710, New Haven, CT 06510, USA; Yale School of Medicine, Clinical Neuroscience Imaging Center, 789 Howard Ave, New Haven, CT 06519, USA
| | - Mohamed Elfil
- Yale School of Medicine, Department of Neurology, Division of Movement Disorders, 15 York St, LCI 710, New Haven, CT 06510, USA; Yale School of Medicine, Clinical Neuroscience Imaging Center, 789 Howard Ave, New Haven, CT 06519, USA
| | - Ahmed Bayoumi
- Yale School of Medicine, Department of Neurology, Division of Movement Disorders, 15 York St, LCI 710, New Haven, CT 06510, USA; Yale School of Medicine, Clinical Neuroscience Imaging Center, 789 Howard Ave, New Haven, CT 06519, USA
| | - Amar Patel
- Yale School of Medicine, Department of Neurology, Division of Movement Disorders, 15 York St, LCI 710, New Haven, CT 06510, USA
| | - Dustin Scheinost
- Yale School of Medicine, Department of Radiology and Biomedical Imaging, 300 Cedar St, New Haven, CT 06519, USA; Yale University, Department of Biomedical Engineering, 17 Hillhouse Avenue, New Haven, CT 06520, USA; Yale School of Medicine, Child Study Center, 230 South Frontage Road, New Haven, CT 06519, USA
| | - Rajita Sinha
- Yale School of Medicine, Yale Stress Center, 2 Church St South, Suite 209, New Haven, CT 06519, USA; Yale School of Medicine, Department of Psychiatry, 300 George St, New Haven, CT 06511, USA; Yale School of Medicine, Department of Neuroscience, 333 Cedar St, SHM-L-200, New Haven, CT 06510, USA
| | - Michelle Hampson
- Yale School of Medicine, Department of Radiology and Biomedical Imaging, 300 Cedar St, New Haven, CT 06519, USA; Yale University, Department of Biomedical Engineering, 17 Hillhouse Avenue, New Haven, CT 06520, USA; Yale School of Medicine, Child Study Center, 230 South Frontage Road, New Haven, CT 06519, USA; Yale School of Medicine, Department of Psychiatry, 300 George St, New Haven, CT 06511, USA
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20
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How D, Wagner H, Brach M. Using Motor Imagery to Access Alternative Attentional Strategies When Navigating Environmental Boundaries to Prevent Freezing of Gait – A Perspective. Front Hum Neurosci 2022; 16:750612. [PMID: 35422692 PMCID: PMC9003572 DOI: 10.3389/fnhum.2022.750612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 02/11/2022] [Indexed: 11/25/2022] Open
Abstract
Freezing of gait can cause reduced independence and quality of life for many with Parkinson’s disease. Episodes frequently occur at points of transition such as navigating a doorway. Therapeutic interventions, i.e., drugs and exercise, do not always successfully mitigate episodes. There are several different, but not exclusive causes for freezing of gait. People with freezing of gait are able to navigate dynamic situations like stairways by utilizing a different attentional strategy to over-ground walking, but may freeze when passing through a doorway. The question is, is it possible to employ a special attentional strategy to prevent freezing at this point? Motor imagery allows for learning motor skills in absolute safety and has been widely employed in a variety of populations, including other neuro-compromised groups. Motor imagery is not studied in a homologous manner in people with Parkinson’s Disease, leading to conflicting results, but may have the potential to establish a different attentional strategy which allows a subject to mitigate freezing of gait episodes. This paper will identify and discuss the questions that still need to be answered in order to consider this approach i.e., can this population access motor imagery, can motor imagery alter the attentional strategy employed when moving through doorways, what is the best motor imagery approach for people with Parkinson’s Disease and freezing of gait, and what dosage is most effective, while briefly outlining future research considerations.
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21
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EEG as a marker of brain plasticity in clinical applications. HANDBOOK OF CLINICAL NEUROLOGY 2022; 184:91-104. [PMID: 35034760 DOI: 10.1016/b978-0-12-819410-2.00029-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Neural networks are dynamic, and the brain has the capacity to reorganize itself. This capacity is named neuroplasticity and is fundamental for many processes ranging from learning and adaptation to new environments to the response to brain injuries. Measures of brain plasticity involve several techniques, including neuroimaging and neurophysiology. Electroencephalography, often used together with other techniques, is a common tool for prognostic and diagnostic purposes, and cortical reorganization is reflected by EEG measurements. Changes of power bands in different cortical areas occur with fatigue and in response to training stimuli leading to learning processes. Sleep has a fundamental role in brain plasticity, restoring EEG bands alterations and promoting consolidation of learning. Exercise and physical inactivity have been extensively studied as both strongly impact brain plasticity. Indeed, EEG studies showed the importance of the physical activity to promote learning and the effects of inactivity or microgravity on cortical reorganization to cope with absent or altered sensorimotor stimuli. Finally, this chapter will describe some of the EEG changes as markers of neural plasticity in neurologic conditions, focusing on cerebrovascular and neurodegenerative diseases. In conclusion, neuroplasticity is the fundamental mechanism necessary to ensure adaptation to new stimuli and situations, as part of the dynamicity of life.
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Cuomo G, Maglianella V, Ghanbari Ghooshchy S, Zoccolotti P, Martelli M, Paolucci S, Morone G, Iosa M. Motor imagery and gait control in Parkinson's disease: techniques and new perspectives in neurorehabilitation. Expert Rev Neurother 2021; 22:43-51. [PMID: 34906019 DOI: 10.1080/14737175.2022.2018301] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Motor imagery (MI), defined as the ability to mentally represent an action without actual movement, has been used to improve motor function in athletes and, more recently, in neurological disorders such as Parkinson's disease (PD). Several studies have investigated the neural correlates of motor imagery, which change also depending on the action imagined. AREAS COVERED This review focuses on locomotion, which is a crucial activity in everyday life and is often impaired by neurological conditions. After a general discussion on the neural correlates of motor imagery and locomotion, we review the evidence highlighting the abnormalities in gait control and gait imagery in PD patients. Next, new perspectives and techniques for PD patients' rehabilitation are discussed, namely Brain Computer Interfaces (BCIs), neurofeedback, and virtual reality (VR). EXPERT OPINION Despite the few studies, the literature review supports the potential beneficial effects of motor imagery interventions in PD focused on locomotion. The development of new technologies could empower the administration of training based on motor imagery locomotor tasks, and their application could lead to new rehabilitation protocols aimed at improving walking ability in patients with PD.
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Affiliation(s)
- Giovanna Cuomo
- Department of Psychology, University of Rome "Sapienza", Rome, Italy
| | | | - Sheida Ghanbari Ghooshchy
- Department of Psychology, University of Rome "Sapienza", Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Pierluigi Zoccolotti
- Department of Psychology, University of Rome "Sapienza", Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Marialuisa Martelli
- Department of Psychology, University of Rome "Sapienza", Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
| | | | | | - Marco Iosa
- Department of Psychology, University of Rome "Sapienza", Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
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Rossi F, Savi F, Prestia A, Mongardi A, Demarchi D, Buccino G. Combining Action Observation Treatment with a Brain-Computer Interface System: Perspectives on Neurorehabilitation. SENSORS 2021; 21:s21248504. [PMID: 34960597 PMCID: PMC8707407 DOI: 10.3390/s21248504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/30/2021] [Accepted: 12/17/2021] [Indexed: 12/04/2022]
Abstract
Action observation treatment (AOT) exploits a neurophysiological mechanism, matching an observed action on the neural substrates where that action is motorically represented. This mechanism is also known as mirror mechanism. In a typical AOT session, one can distinguish an observation phase and an execution phase. During the observation phase, the patient observes a daily action and soon after, during the execution phase, he/she is asked to perform the observed action at the best of his/her ability. Indeed, the execution phase may sometimes be difficult for those patients where motor impairment is severe. Although, in the current practice, the physiotherapist does not intervene on the quality of the execution phase, here, we propose a stimulation system based on neurophysiological parameters. This perspective article focuses on the possibility to combine AOT with a brain–computer interface system (BCI) that stimulates upper limb muscles, thus facilitating the execution of actions during a rehabilitation session. Combining a rehabilitation tool that is well-grounded in neurophysiology with a stimulation system, such as the one proposed, may improve the efficacy of AOT in the treatment of severe neurological patients, including stroke patients, Parkinson’s disease patients, and children with cerebral palsy.
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Affiliation(s)
- Fabio Rossi
- Department of Electronics and Telecommunications, Politecnico di Torino, 10129 Turin, Italy; (F.R.); (A.P.); (A.M.); (D.D.)
| | - Federica Savi
- Fondazione Don Carlo Gnocchi, Piazzale dei Servi 3, 43100 Parma, Italy;
| | - Andrea Prestia
- Department of Electronics and Telecommunications, Politecnico di Torino, 10129 Turin, Italy; (F.R.); (A.P.); (A.M.); (D.D.)
| | - Andrea Mongardi
- Department of Electronics and Telecommunications, Politecnico di Torino, 10129 Turin, Italy; (F.R.); (A.P.); (A.M.); (D.D.)
| | - Danilo Demarchi
- Department of Electronics and Telecommunications, Politecnico di Torino, 10129 Turin, Italy; (F.R.); (A.P.); (A.M.); (D.D.)
| | - Giovanni Buccino
- Division of Neuroscience, IRCCS San Raffaele Scientific Institute, University San Raffaele, Via Olgettina 60, 20132 Milan, Italy
- Correspondence: ; Tel.: +39-02-91751596
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Heena N, Zia NU, Sehgal S, Anwer S, Alghadir A, Li H. Effects of task complexity or rate of motor imagery on motor learning in healthy young adults. Brain Behav 2021; 11:e02122. [PMID: 34612612 PMCID: PMC8613406 DOI: 10.1002/brb3.2122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 01/26/2021] [Accepted: 03/06/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND A growing body of evidence suggests the benefit of motor imagery in motor learning. While some studies tried to look at the effect of isolated mental practice, others evaluated the combined effect of motor imagery and physical practice in clinical rehabilitation. This study aimed to investigate the effects of task complexity or rates of motor imagery on motor learning in health young adults. METHODS Eighty-eight healthy individuals participated in this study. Participants were randomly allocated to either Group A (50% complex, N = 22), Group B (75% complex, N = 22), Group C (50% simple, N = 22), or Group D (75% simple, N = 22). Participants in the complex groups performed their task with nondominant hand and those in simple groups with a dominant hand. All participants performed a task that involved reach, grasp, and release tasks. The performance of the four groups was examined in the acquisition and retention phase. The main outcome measure was the movement time. RESULTS There were significant differences between immediate (i.e., acquisition) and late (i.e., retention) movement times at all three stages of task (i.e., MT1 [reaching time], MT2 [target transport time], and TMT [reaching time plus object transport time]) when individuals performed complex task with 75% imagery rate (p < .05). Similarly, there were significant differences between immediate and late movement times at all stages of task except the MT2 when individuals performed simple task with 75% imagery rate (p < .05). There were significant effects of task complexity (simple vs. complex tasks) on immediate movement time at the first stage of task (i.e., MT1 ) and late movement times of all three stages of task (p < .05). There were significant effects of the rate of imagery (50% vs. 75%) on late movement times at all three stages of tasks (p > .05). Additionally, there were no interaction effects of either task complexity or rate of imagery on both immediate and late movement times at all three stages of tasks (p > .05). CONCLUSION This study supports the use of higher rates (75%) of motor imagery to improve motor learning. Additionally, the practice of a complex task demonstrated better motor learning in healthy young adults. Future longitudinal studies should validate these results in different patient's population such as stroke, spinal cord injury, and Parkinson's disease.
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Affiliation(s)
- Nargis Heena
- Max Smart Super Specialty HospitalNew DelhiIndia
| | - Nayeem U. Zia
- Directorate of Health Services KashmirJammu and KashmirIndia
| | - Stuti Sehgal
- Institution of Rehabilitation Sciences, ISIC Vasant KunjNew DelhiIndia
| | - Shahnawaz Anwer
- Rehabilitation Research ChairCollege of Applied Medical SciencesKing Saud UniversityRiyadhSaudi Arabia
- Department of Building and Real EstateHong Kong Polytechnic UniversityKowloonHong Kong Special Administrative Region
| | - Ahmad Alghadir
- Rehabilitation Research ChairCollege of Applied Medical SciencesKing Saud UniversityRiyadhSaudi Arabia
| | - Heng Li
- Department of Building and Real EstateHong Kong Polytechnic UniversityKowloonHong Kong Special Administrative Region
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Action Imagery and Observation in Neurorehabilitation for Parkinson's Disease (ACTION-PD): Development of a User-Informed Home Training Intervention to Improve Functional Hand Movements. PARKINSONS DISEASE 2021; 2021:4559519. [PMID: 34336183 PMCID: PMC8324342 DOI: 10.1155/2021/4559519] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 06/28/2021] [Accepted: 07/12/2021] [Indexed: 01/21/2023]
Abstract
Background Parkinson's disease (PD) causes difficulties with hand movements, which few studies have addressed therapeutically. Training with action observation (AO) and motor imagery (MI) improves performance in healthy individuals, particularly when the techniques are applied simultaneously (AO + MI). Both AO and MI have shown promising effects in people with PD, but previous studies have only used these separately. Objective This article describes the development and pilot testing of an intervention combining AO + MI and physical practice to improve functional manual actions in people with PD. Methods The home-based intervention, delivered using a tablet computer app, was iteratively designed by an interdisciplinary team, including people with PD, and further developed through focus groups and initial field testing. Preliminary data on feasibility were obtained via a six-week pilot randomised controlled trial (ISRCTN 11184024) of 10 participants with mild to moderate PD (6 intervention; 4 treatment as usual). Usage and adherence data were recorded during training, and semistructured interviews were conducted with participants. Exploratory outcome measures included dexterity and timed action performance. Results Usage and qualitative data provided preliminary evidence of acceptability and usability. Exploratory outcomes also suggested that subjective and objective performance of manual actions should be tested in a larger trial. The importance of personalisation, choice, and motivation was highlighted, as well as the need to facilitate engagement in motor imagery. Conclusions The results indicate that a larger RCT is warranted, and the findings also have broader relevance for the feasibility and development of AO + MI interventions for PD and other conditions.
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Sarasso E, Agosta F, Piramide N, Gardoni A, Canu E, Leocadi M, Castelnovo V, Basaia S, Tettamanti A, Volontè MA, Filippi M. Action Observation and Motor Imagery Improve Dual Task in Parkinson's Disease: A Clinical/fMRI Study. Mov Disord 2021; 36:2569-2582. [PMID: 34286884 DOI: 10.1002/mds.28717] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 06/25/2021] [Accepted: 06/28/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Action observation training and motor imagery may improve motor learning in Parkinson's disease (PD). OBJECTIVES The objectives of this study were to assess mobility and balance (performing motor and dual tasks) and brain functional reorganization following 6 weeks of action observation training and motor imagery associated with dual-task gait/balance exercises in PD patients with postural instability and gait disorders relative to dual-task training alone. METHODS Twenty-five PD-postural instability and gait disorder patients were randomized into 2 groups: the DUAL-TASK+AOT-MI group performed a 6-week gait/balance training consisting of action observation training-motor imagery combined with practicing the observed-imagined exercises; the DUAL-TASK group performed the same exercises combined with watching landscape videos. Exercises were increasingly difficult to include the dual task. At baseline and at 6 weeks, patients underwent: mobility, gait, and balance evaluations (also repeated 2 months after training), cognitive assessment, and functional MRI, including motor and dual tasks. RESULTS Dual-task gait/balance training enhanced mobility, during both single- and dual-task conditions, and executive functions in PD-postural instability and gait disorders, with a long-lasting effect at 14 weeks. When exercises were preceded by action observation training-motor imagery, PD-postural instability and gait disorders showed greater improvement of balance and gait velocity both with and without the dual task, particularly during the turning phase. After training, the DUAL-TASK+AOT-MI group showed reduced recruitment of frontal areas and increased activity of cerebellum during functional-MRI motor and dual task, correlating with balance/turning velocity and executive improvements, respectively. The DUAL-TASK group showed reduced activity of supplementary motor area and increased recruitment of temporo-parietal areas during the dual task and decreased cerebellar activity during the motor task correlating with faster turning velocity. Functional MRI results were not corrected for multiple comparisons and should be interpreted carefully. CONCLUSIONS Adding action observation training-motor imagery to dual-task gait/balance training promotes specific functional reorganization of brain areas involved in motor control and executive-attentive abilities and more long-lasting effects on dual-task mobility and balance in PD-postural instability and gait disorders. © 2021 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Elisabetta Sarasso
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Federica Agosta
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Noemi Piramide
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Andrea Gardoni
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Elisa Canu
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Michela Leocadi
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Veronica Castelnovo
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Silvia Basaia
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Andrea Tettamanti
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Massimo Filippi
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy.,Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy
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Abraham A, Duncan RP, Earhart GM. The Role of Mental Imagery in Parkinson's Disease Rehabilitation. Brain Sci 2021; 11:brainsci11020185. [PMID: 33540883 PMCID: PMC7913152 DOI: 10.3390/brainsci11020185] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/26/2021] [Accepted: 01/28/2021] [Indexed: 02/06/2023] Open
Abstract
Parkinson’s disease (PD) is a disabling neurodegenerative disease whose manifestations span motor, sensorimotor, and sensory domains. While current therapies for PD include pharmacological, invasive, and physical interventions, there is a constant need for developing additional approaches for optimizing rehabilitation gains. Mental imagery is an emerging field in neurorehabilitation and has the potential to serve as an adjunct therapy to enhance patient function. Yet, the literature on this topic is sparse. The current paper reviews the motor, sensorimotor, and sensory domains impacted by PD using gait, balance, and pain as examples, respectively. Then, mental imagery and its potential for PD motor and non-motor rehabilitation is discussed, with an emphasis on its suitability for addressing gait, balance, and pain deficits in people with PD. Lastly, future research directions are suggested.
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Affiliation(s)
- Amit Abraham
- Department of Physical Therapy, Faculty of Health Sciences, Ariel University, Ariel 4077625, Israel
- Navigation and Accessibility Research Center of Ariel University (NARCA), Ariel University, Ariel 4077625, Israel
- Correspondence:
| | - Ryan P. Duncan
- Program in Physical Therapy, Washington University in St. Louis School of Medicine, St. Louis, MO 63108, USA; (R.P.D.); (G.M.E.)
- Department of Neurology, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA
| | - Gammon M. Earhart
- Program in Physical Therapy, Washington University in St. Louis School of Medicine, St. Louis, MO 63108, USA; (R.P.D.); (G.M.E.)
- Department of Neurology, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA
- Department of Neuroscience, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA
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Paravlic AH, Maffulli N, Kovač S, Pisot R. Home-based motor imagery intervention improves functional performance following total knee arthroplasty in the short term: a randomized controlled trial. J Orthop Surg Res 2020; 15:451. [PMID: 33008432 PMCID: PMC7531130 DOI: 10.1186/s13018-020-01964-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 09/14/2020] [Indexed: 11/22/2022] Open
Abstract
Background Motor imagery (MI) is effective in improving motor performance in the healthy asymptomatic adult population. However, its possible effects among older orthopaedic patients are still poorly investigated. Therefore, this study explored whether the addition of motor imagery to routine physical therapy reduces the deterioration of quadriceps muscle strength and voluntary activation (VA) as well as other variables related to motor performance in patients after total knee arthroplasty (TKA). Methods Twenty-six patients scheduled for TKA were randomized to either MI practice combined with routine physical therapy group (MIp) or to a control group receiving physical therapy alone (CON). MIp consisted of maximal voluntary isometric contraction (MViC) task: 15 min/day in the hospital, then 5 times/week in their homes for 4 weeks. MViC and VA of quadriceps muscle, knee flexion and extension range of motion, pain level, along with a Timed Up-and-Go Test (TUG) and self-reported measure of physical function (assessed using the Oxford Knee Score questionnaire [OKS]) were evaluated before (PRE) and 1 month after surgery (POST). Results Significantly better rehabilitation outcomes were evident on the operated leg for the MIp group compared to CON: at POST, the MIp showed lower strength decrease (p = 0.012, η2= 0.237) and unaltered VA, significantly greater than CON (p = 0.014, η2= 0.227). There were no significant differences in knee flexion and extension range of motion and pain level (p > 0.05). Further, MIp patients performed better in TUG (p < 0.001, η2= 0.471) and reported better OKS scores (p = 0.005, η2= 0.280). The non-operated leg showed no significant differences in any outcomes at POST (all p > 0.05). In addition, multiple linear regression analysis showed that failure of voluntary activation explained 47% of the quadriceps muscle strength loss, with no significant difference in perceived level of pain. Conclusion MI practice, when added to physical therapy, improves both objective and subjective measures of patients’ physical function after TKA, and facilitates transfer of MI strength task on functional mobility. Trial registration Retrospectively registered on ClinicalTrials.govNCT03684148
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Affiliation(s)
- Armin H Paravlic
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia
| | - Nicola Maffulli
- Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Salerno, Italy. .,Centre for Sports and Exercise Medicine, Queen Mary University of London, London, UK. .,School of Pharmacy and Bioengineering, Keele University School of Medicine, Stoke on Trent, UK.
| | - Simon Kovač
- Orthopaedic Hospital Valdoltra, Ankaran, Slovenia
| | - Rado Pisot
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia.,Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
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Aoyama T, Kaneko F, Kohno Y. Motor imagery combined with action observation training optimized for individual motor skills further improves motor skills close to a plateau. Hum Mov Sci 2020; 73:102683. [DOI: 10.1016/j.humov.2020.102683] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 09/02/2020] [Accepted: 09/08/2020] [Indexed: 11/27/2022]
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Szynkiewicz SH, Kamarunas E, Drulia T, Nobriga CV, Griffin L, O'Donoghue CR. A Randomized Controlled Trial Comparing Physical and Mental Lingual Exercise for Healthy Older Adults. Dysphagia 2020; 36:474-482. [PMID: 32770381 DOI: 10.1007/s00455-020-10164-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 07/25/2020] [Indexed: 11/25/2022]
Abstract
Mental practice using motor imagery (MP-MI) has been shown to improve motor outcomes of upper and lower extremities especially when combined with physical exercise. Here, we studied community-dwelling, healthy older adults to determine the effects of including an MP-MI component with lingual strengthening exercise. In this pilot study, twenty-nine typically aging participants were assigned to an intervention group: physical lingual exercise (n = 7), physical and MP-MI lingual exercise (n = 8), MPMI lingual exercise (n = 7), or a control group (placebo exercise) (n = 7). All participants completed the assigned exercise regimen with three sessions per day, three days a week, for 6 consecutive weeks. Maximum isometric pressure (MIP) and regular effort saliva swallowing (RESS) pressure were collected at baseline and weeks 2, 4, and 6. A post hoc Bonferroni corrected treatment effect from baseline to week 6 was shown for only participants in the MP-MI/Physical exercise group for MIP (p = 0.003 MPMI/ Physical group; p = 0.11 Control group; p = 0.32 Physical only group; p = 0.14 MP-MI only group) and RESS (p = 0.009 MP-MI/Physical group; p = 0.14 Control group; p = 0.10 Physical only group; p = 0.04 MP-MI only group). Findings also indicate spontaneous carryover of significantly increased swallowing pressure when mental and physical exercise are combined. In conclusion, the potential effect of including an MPMI lingual exercise component in preventative and rehabilitative frameworks with older persons to possibly enhance functional swallowing improvement is promising and should be investigated.
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Affiliation(s)
- Sarah H Szynkiewicz
- College of Science and Mathematics, Communication Sciences and Disorders, University of South Florida, Sarasota-Manate, 8350 N. Tamiami Trail, Sarasota, FL, 34243, USA. .,School of Health Professions, Communication Sciences and Disorders, Samford University, 800 Lakeshore Drive, Birmingham, AL, 35229, USA.
| | - Erin Kamarunas
- College of Health and Behavioral Studies, Communication Sciences and Disorders, James Madison University, MSC 4304, 235 Martin Luther King Jr. Way, Harrisonburg, VA, 22807, USA
| | - Teresa Drulia
- Harris College of Nursing and Health Sciences, Davies School of Communication Sciences and Disorders, Texas Christian University, TCU Box 297450, Fort Worth, TX, 76109, USA
| | - Christina V Nobriga
- School of Allied Health Professions, Communication Sciences and Disorders, Loma Linda University, Loma Linda, CA, 92350, USA
| | - Lindsay Griffin
- College of Health and Behavioral Studies, Communication Sciences and Disorders, James Madison University, MSC 4304, 235 Martin Luther King Jr. Way, Harrisonburg, VA, 22807, USA.,School of Communications, Communication Sciences and Disorders, Emerson College, 120 Boylston Street, Boston, MA, 02116, USA
| | - Cynthia R O'Donoghue
- College of Health and Behavioral Studies, Communication Sciences and Disorders, James Madison University, MSC 4304, 235 Martin Luther King Jr. Way, Harrisonburg, VA, 22807, USA
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Cherup NP, Strand KL, Lucchi L, Wooten SV, Luca C, Signorile JF. Yoga Meditation Enhances Proprioception and Balance in Individuals Diagnosed With Parkinson's Disease. Percept Mot Skills 2020; 128:304-323. [PMID: 32746736 DOI: 10.1177/0031512520945085] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
This study compared the effectiveness of two proprioceptive exercise programs for persons diagnosed with Parkinson's disease (PD). Thirty-three patients with mild to moderate PD were randomly assigned to a yoga meditation program (YoMed) or to an established proprioceptive training program (PRO). Both interventions included twice weekly sessions (45 minutes each), spanning a 12-week period. Outcome measures included: joint position sense (JPS45°, JPS55°, JPS65°) and joint kinesthesia (JKFlex and JKExt), the Tinetti Balance Assessment Tool (TIN), Falls Efficacy Scale (FES), Balance Error Scoring System (BESS), dynamic posturography (DMA and TIME) and the Timed Up-and-Go Test (TUG). Test administrators were blinded to group affiliation. Significant between-group differences favoring the YoMed group were observed for TIN (p = 0.01, d = 0.77) and JKFlex (p = 0.05, d = -0.72). DMA and TIME scores significantly improved for both groups, and no adverse events were reported. These findings indicate that the YoMed program is safe and effective for patients with PD. Researchers should continue to examine the clinical efficacy of mind-body techniques to improve movement control and body awareness in this population.
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Affiliation(s)
- Nicholas P Cherup
- Laboratory of Neuromuscular Research and Active Aging, Department of Kinesiology and Sport Sciences, University of Miami
| | - Keri L Strand
- Laboratory of Neuromuscular Research and Active Aging, Department of Kinesiology and Sport Sciences, University of Miami
| | - Lucrezia Lucchi
- Laboratory of Neuromuscular Research and Active Aging, Department of Kinesiology and Sport Sciences, University of Miami
| | - Savannah V Wooten
- Laboratory of Neuromuscular Research and Active Aging, Department of Kinesiology and Sport Sciences, University of Miami
| | - Corneliu Luca
- Miller School of Medicine, Soffer Clinical Research Center, University of Miami
| | - Joseph F Signorile
- Laboratory of Neuromuscular Research and Active Aging, Department of Kinesiology and Sport Sciences, University of Miami.,Miller School of Medicine, Center on Aging, University of Miami
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32
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Complementary Health Approaches for People With Parkinson Disease. Arch Phys Med Rehabil 2020; 101:1475-1477. [DOI: 10.1016/j.apmr.2020.03.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 03/30/2020] [Indexed: 11/18/2022]
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33
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Miladinovic A, Ajcevic M, Busan P, Jarmolowska J, Silveri G, Deodato M, Mezzarobba S, Battaglini PP, Accardo A. Evaluation of Motor Imagery-Based BCI methods in neurorehabilitation of Parkinson's Disease patients. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2020:3058-3061. [PMID: 33018650 DOI: 10.1109/embc44109.2020.9176651] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The study reports the performance of Parkinson's disease (PD) patients to operate Motor-Imagery based Brain-Computer Interface (MI-BCI) and compares three selected pre-processing and classification approaches. The experiment was conducted on 7 PD patients who performed a total of 14 MI-BCI sessions targeting lower extremities. EEG was recorded during the initial calibration phase of each session, and the specific BCI models were produced by using Spectrally weighted Common Spatial Patterns (SpecCSP), Source Power Comodulation (SPoC) and Filter-Bank Common Spatial Patterns (FBCSP) methods. The results showed that FBCSP outperformed SPoC in terms of accuracy, and both SPoC and SpecCSP in terms of the false-positive ratio. The study also demonstrates that PD patients were capable of operating MI-BCI, although with lower accuracy.
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Stuckenschneider T, Askew CD, Menêses AL, Baake R, Weber J, Schneider S. The Effect of Different Exercise Modes on Domain-Specific Cognitive Function in Patients Suffering from Parkinson's Disease: A Systematic Review of Randomized Controlled Trials. JOURNAL OF PARKINSONS DISEASE 2020; 9:73-95. [PMID: 30741688 DOI: 10.3233/jpd-181484] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Supervised exercise training alleviates motor symptoms in people with Parkinson's disease (PD). However, the efficacy of exercise to improve nonmotor symptoms such as cognitive function is less well known. OBJECTIVE To systematically review evidence on the efficacy of different exercise modes (coordination exercise, resistance exercise, aerobic exercise) on domain-specific cognitive function in patients with PD. METHODS Parallel-group randomized controlled trials published before March 2018 were included. Primary outcome measures included global cognitive function and its subdomains, and the Unified Parkinson's Disease Rating Scale was included as a secondary outcome. Methodological quality was assessed using the Physiotherapy Evidence Database scale. RESULTS The literature search yielded 2,000 articles, of which 11 met inclusion criteria. 508 patients (mean age 68±4 years) were included with a disease severity from 1 to 4 on the Hoehn & Yahr stage scale. Overall study quality was modest (mean 6±2, range 3-8/10). In 5 trials a significant between-group effect size (ES) was identified for tests of specific cognitive domains, including a positive effect of aerobic exercise on memory (ES = 2.42) and executive function (ES = 1.54), and of combined resistance and coordination exercise on global cognitive function (ES = 1.54). Two trials found a significant ES for coordination exercise (ES = 0.84-1.88), which led to improved executive function compared with that of non-exercising control subjects. CONCLUSION All modes of exercise are associated with improved cognitive function in individuals with PD. Aerobic exercise tended to best improve memory; however, a clear effect of exercise mode was not identified.
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Affiliation(s)
- Tim Stuckenschneider
- Institute of Movement and Neurosciences, German Sport University, Cologne, Germany.,VasoActive Research Group, School of Health and Sport Sciences, University of the Sunshine Coast, QLD, Australia
| | - Christopher D Askew
- VasoActive Research Group, School of Health and Sport Sciences, University of the Sunshine Coast, QLD, Australia
| | - Annelise L Menêses
- VasoActive Research Group, School of Health and Sport Sciences, University of the Sunshine Coast, QLD, Australia
| | - Ricarda Baake
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Jan Weber
- Institute of Movement and Neurosciences, German Sport University, Cologne, Germany
| | - Stefan Schneider
- Institute of Movement and Neurosciences, German Sport University, Cologne, Germany.,VasoActive Research Group, School of Health and Sport Sciences, University of the Sunshine Coast, QLD, Australia
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Chen J, Kan W, Liu Y, Hu X, Wu T, Zou Y, Liu H, Yang K. Frequency-specific equivalence of brain activity on motor imagery during action observation and action execution. Int J Neurosci 2020; 131:599-608. [PMID: 32228346 DOI: 10.1080/00207454.2020.1750394] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Human motor imagery (MI), action execution, and action observation (AO) are functionally considered as equivalent. MI during AO can extensively induce activation of motor-related brain network in the absence of overt movement. The magnetoencephalography (MEG) provides an important technology to reveal and reflect human brain information processing in multi-frequency bands. Utilizing a MEG system, we aimed to quantitatively investigate the frequency-specific equivalent characteristics in brain processing patterns between MI during AO and action execution in multi-frequency bands, including delta, theta, alpha, beta, gamma, and high-frequency oscillations. METHODS A total of 12 healthy subjects were studied with a whole-head MEG system during finger movement and MI during finger movement observation. We analyzed the brain activities in multi-frequency ranges of 1 Hz to 200 Hz. RESULTS Both MI during AO and action execution evoked the distinctive brain activities in low frequency ranges (i.e. delta, theta, and alpha). Significant differences were found in global spectral power between finger movement and MI during AO in delta and alpha oscillations. Compared with finger movement, delta (1-4 Hz) oscillation power in MI during AO were obviously decreased in left and right frontals and occipitals, and theta (4-8 Hz) and alpha (8-13 Hz) oscillation power were obviously increased in frontal, parietal and occipital. CONCLUSION MEG power evoked by finger movement and MI during AO is mainly concentrated in the energy distribution below 13 Hz. Furthermore, finger movement and MI during AO might share frequency-specific equivalence of brain neural activation dependent on different MEG frequency ranges.
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Affiliation(s)
- Jiu Chen
- Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Fourth Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China.,Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Wenwu Kan
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yong Liu
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xinhua Hu
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Ting Wu
- MEG Center, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yuanjie Zou
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hongyi Liu
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Kun Yang
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
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Ferrazzoli D, Ortelli P, Cucca A, Bakdounes L, Canesi M, Volpe D. Motor-cognitive approach and aerobic training: a synergism for rehabilitative intervention in Parkinson's disease. Neurodegener Dis Manag 2020; 10:41-55. [PMID: 32039653 DOI: 10.2217/nmt-2019-0025] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Parkinson's disease (PD) results in a complex deterioration of motor behavior. Effective pharmacological or surgical treatments addressing the whole spectrum of both motor and cognitive symptoms are lacking. The cumulative functional impairment may have devastating socio-economic consequences on both patients and caregivers. Comprehensive models of care based on multidisciplinary approaches may succeed in better addressing the overall complexity of PD. Neurorehabilitation is a highly promising non-pharmacological intervention for managing PD. The scientific rationale beyond rehabilitation and its practical applicability remain to be established. In the present perspective, we aim to discuss the current evidence supporting integrated motor-cognitive and aerobic rehabilitation approaches for patients with PD while suggesting a practical framework to optimize this intervention in the next future.
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Affiliation(s)
- Davide Ferrazzoli
- Fresco Parkinson Center, Department of Parkinson's disease, Movement Disorders & Brain Injury Rehabilitation, 'Moriggia-Pelascini' Hospital - Gravedona ed Uniti, Como, 22015, Italy
| | - Paola Ortelli
- Fresco Parkinson Center, Department of Parkinson's disease, Movement Disorders & Brain Injury Rehabilitation, 'Moriggia-Pelascini' Hospital - Gravedona ed Uniti, Como, 22015, Italy
| | - Alberto Cucca
- Fresco Parkinson Center, Villa Margherita, S. Stefano Riabilitazione, Vicenza, 36057, Italy.,The Marlene & Paolo Fresco Institute for Parkinson's & Movement Disorders, Department of Neurology, NYU School of Medicine, New York, NY 10017, USA
| | - Leila Bakdounes
- Fresco Parkinson Center, Villa Margherita, S. Stefano Riabilitazione, Vicenza, 36057, Italy
| | - Margherita Canesi
- Fresco Parkinson Center, Department of Parkinson's disease, Movement Disorders & Brain Injury Rehabilitation, 'Moriggia-Pelascini' Hospital - Gravedona ed Uniti, Como, 22015, Italy
| | - Daniele Volpe
- Fresco Parkinson Center, Villa Margherita, S. Stefano Riabilitazione, Vicenza, 36057, Italy
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Bek J, Arakaki AI, Lawrence A, Sullivan M, Ganapathy G, Poliakoff E. Dance and Parkinson's: A review and exploration of the role of cognitive representations of action. Neurosci Biobehav Rev 2019; 109:16-28. [PMID: 31846651 DOI: 10.1016/j.neubiorev.2019.12.023] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 11/30/2019] [Accepted: 12/13/2019] [Indexed: 10/25/2022]
Abstract
Parkinson's disease (PD) is a neurodegenerative condition that causes both sensorimotor and non-motor impairments, and there is a clear need for non-medical approaches to improve quality of life. Dance is an increasingly popular activity among people with PD, which demonstrates potential therapeutic benefits. However, findings to date have been inconsistent, and little is known about the mechanisms underlying benefits of dance in PD. In this review, we provide an overview of research into dance for people with PD. The majority of quantitative evidence is in the sensorimotor domain, but cognitive, psychological and social effects have also been reported. We consider the role of cognitive representations of action within dance through observation, imitation and imagery, which may contribute to both sensorimotor and non-motor outcomes for people with PD. Moreover, we discuss how these processes may be enhanced through dance to provide further benefits in everyday life. Finally, we propose avenues for future research to increase understanding of action representation in dance for PD, which has the potential to inform practice and maximize benefits.
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Affiliation(s)
- Judith Bek
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom.
| | - Aline I Arakaki
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom.
| | - Adam Lawrence
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom.
| | - Matthew Sullivan
- School of Science and the Environment, E432 John Dalton Building, Manchester Metropolitan University, Oxford Road, Manchester, M16 5BH, United Kingdom.
| | - Gayathri Ganapathy
- Equilibrium International, 6 Stretton Avenue, Manchester, M20 6HE, United Kingdom.
| | - Ellen Poliakoff
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom.
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Saruco E, Guillot A, Multari L, Saimpont A. Effects of Different Ratios of Physical and Mental Practice on Postural Control Improvement. J Mot Behav 2019; 52:723-733. [PMID: 31813332 DOI: 10.1080/00222895.2019.1689908] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Mental practice (MP) is a reliable alternative or complement to physical practice (PP) for the training of postural control. We address how MP should ideally be combined with PP. Participants were assigned to four experimental groups where MP/PP ratios during training varied from 0 to 100%. Performance improved only for demanding postural adjustments, regardless of MP/PP ratio, and learning was partially consolidated after a night of sleep. Findings reinforce the relevance of MP for the training of weight shifting and further suggest that MP alone can be as efficient as PP for the learning of certain complex postural adjustments.
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Affiliation(s)
- Elodie Saruco
- Laboratoire Interuniversitaire de Biologie de la Motricité, University of Lyon Villeurbanne, France.,Neurologische Universitätsklinik, Bergmannsheil gGmbH, Forschungsgruppe Plastizität. Bürkle-de-la-Camp-Platz, Bochum, Germany
| | - Aymeric Guillot
- Laboratoire Interuniversitaire de Biologie de la Motricité, University of Lyon Villeurbanne, France
| | - Léa Multari
- Laboratoire Interuniversitaire de Biologie de la Motricité, University of Lyon Villeurbanne, France
| | - Arnaud Saimpont
- Laboratoire Interuniversitaire de Biologie de la Motricité, University of Lyon Villeurbanne, France
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Pondé PDDS, Krause Neto W, Rodrigues DN, Cristina L, Bastos MF, Sanches IC, Gama EF. CHRONIC RESPONSES OF PHYSICAL AND IMAGERY TRAINING ON PARKINSON’S DISEASE. REV BRAS MED ESPORTE 2019. [DOI: 10.1590/1517-869220192506214238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Introduction Physical and motor imagery training is known to induce positive results in the quality of life of patients with neurodegenerative diseases. However, it is not known which effects are achievable when both types of training are combined. Objective This study aimed to investigate the effects of a combination of physical and imagery training on neurotrophin levels, the perception of body dimensions and activities of daily living (ADL) in individuals with Parkinson’s disease (PD). Methods Over an 8-week period, thirteen subjects underwent one hour of aerobic training in combination with twice-weekly imagery training (MIT). The following parameters were measured: brain-derived neurotrophic factor (BDNF) serum levels, level of dependence for activities of daily living (ADLs – Basic [ABDL] and Instrumental [AIDL]), perception of body dimensions and hand laterality test. Results Physical training combined with MIT increased serum BDNF levels in a non-statistically significant manner by 128.08% (88.81 ± 111.83 pg/ml versus 202.56 ± 183.43 pg/ml, p= 0.068). Delta BDNF showed a mean variation of 218.05 ± 547.55% (ES = 1.04). Perception of body dimensions and hand recognition reaction time both improved, but not in a non-statistically significant manner. ADLs (9.52% in ABDLs and 17.76% in AIDLs) improved in a statistically significant manner. Conclusion Despite the small number of subjects, study limitations, and the fact that most results were non-statistically significant, the results obtained here indicate clinical improvement associated with the neurotrophic action of BDNF on the perception of body dimensions and the functional capacity of Parkinson’s disease subjects. Level of evidence II, Therapeutic studies–Investigation of treatment results.
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Affiliation(s)
| | | | | | | | | | | | - Eliane Florencio Gama
- Universidade São Judas Tadeu, Brazil; Universidade São Judas Tadeu, Brazil; Universidade São Judas Tadeu, Brazil
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Effects of motor imagery training of Parkinson's disease: a protocol for a randomized clinical trial. Trials 2019; 20:626. [PMID: 31706325 PMCID: PMC6842520 DOI: 10.1186/s13063-019-3694-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 08/31/2019] [Indexed: 11/10/2022] Open
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. Electronic supplementary material The online version of this article (10.1186/s13063-019-3694-8) contains supplementary material, which is available to authorized users.
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Chen J, Yan Y, Gu L, Gao L, Zhang Z. Electrophysiological Processes on Motor Imagery Mediate the Association Between Increased Gray Matter Volume and Cognition in Amnestic Mild Cognitive Impairment. Brain Topogr 2019; 33:255-266. [PMID: 31691911 DOI: 10.1007/s10548-019-00742-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 10/26/2019] [Indexed: 11/29/2022]
Abstract
Motor imagery is considered as an ideal window to observe neural processes of action representations. Behavioral evidence has indicated an alteration of motor imagery in amnestic mild cognitive impairment (aMCI). However, it still remains unclear on the altered neurophysiological processing mechanism of motor imagery and whether this mechanism links the abnormal biological basis of motor imagery with impaired cognition in aMCI. This study was to investigate the altered neurophysiological processing mechanism of motor imagery and to examine the relationships between this knowledge and the altered structural basis of motor imagery with impaired cognition in aMCI. A hand mental rotation paradigm was used to manipulate the processing of motor imagery while event-related brain potentials (ERPs) were recorded and gray matter (GM) voxel-based morphometry was performed in 20 aMCI and 29 healthy controls. Compared with controls, aMCI exhibited lower ERP amplitudes in parietal cortex and higher ERP amplitudes in frontal cortex during motor imagery. In addition, aMCI showed reduced GM volumes in cerebellum posterior lobe, insula and hippocampus/parahippocampal gyrus, and increased GM volumes in middle cingulate gyrus and superior frontal gyrus. Most importantly, increased ERP amplitude significantly mediated the association between increased GM and cognition. This study provided a novel evidence for the relationships between the electrophysiological processing mechanism and structural basis of motor imagery with impaired cognition in aMCI. It suggests that improving neural activity by stimulating the frontal lobe can potentially contribute to acquire motor imagery skills for neurological rehabilitation in aMCI subjects.
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Affiliation(s)
- Jiu Chen
- Department of Psychology, Xinxiang Medical University, Xinxiang, 453003, Henan, China. .,Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, 210009, Jiangsu, China. .,Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Fourth Clinical College of Nanjing Medical University, Nanjing, 210029, Jiangsu, China.
| | - Yanna Yan
- Department of Psychology, Xinxiang Medical University, Xinxiang, 453003, Henan, China
| | - Lihua Gu
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, 210009, Jiangsu, China
| | - Lijuan Gao
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, 210009, Jiangsu, China
| | - Zhijun Zhang
- Department of Psychology, Xinxiang Medical University, Xinxiang, 453003, Henan, China. .,Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, 210009, Jiangsu, China.
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Fil-Balkan A, Salci Y, Keklicek H, Armutlu K, Aksoy S, Kayihan H, Elibol B. Sensorimotor integration training in Parkinson`s disease. ACTA ACUST UNITED AC 2019; 23:208-215. [PMID: 30007996 PMCID: PMC8015575 DOI: 10.17712/nsj.2018.3.20180021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To determine the effects of sensorimotor integration training on postural control in Parkinson`s disease. METHODS This prospective, randomized controlled trial was conducted at Hacettepe University (Ankara, Turkey). The study was carried out from August 2012 until March 2015 and included 24 Parkinson`s patients with stage 2-3 according to the Modified Hoehn&Yahr Rating Scale. The patients were divided into 2 groups (control and study). The control group received conventional physiotherapy; the study group received sensorimotor integration training combined with conventional physiotherapy, 2 times per week for 6 weeks. We assessed the patients with clinical balance tests and computerized dynamic posturography. Assessments were performed at baseline, 7- and 12-weeks follow-up. RESULTS Computerized dynamic posturography posturography values (5th and 6th positions, composite balance, and vestibular system scores) were higher in the study group than in the control group. The improvements were maintained at the 12-week follow up except 6th positions scores (p<0.05). CONCLUSION Sensorimotor integration training combined with conventional physiotherapy approach ameliorated postural control by improving vestibular system in patients with Parkinson`s disease by improving sensory processes.
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Affiliation(s)
- Ayla Fil-Balkan
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey. E-mail:
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Silva LPD, Duarte MPDS, Souza CDCBD, Lins CCDSA, Coriolano MDGWDS, Lins OG. Efeitos da prática mental associada à fisioterapia motora sobre a marcha e o risco de quedas na doença de Parkinson: estudo piloto. FISIOTERAPIA E PESQUISA 2019. [DOI: 10.1590/1809-2950/17012926022019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO O objetivo deste estudo piloto, realizado em um hospital universitário de referência em Pernambuco, foi avaliar os efeitos da prática mental associada à fisioterapia motora sobre a marcha e o risco de queda em pessoas com doença de Parkinson. A amostra da pesquisa foi composta por 18 sujeitos, de ambos os sexos, com doença de Parkinson idiopática, divididos em grupo experimental (8 indivíduos) e controle (10 indivíduos). Ambos os grupos realizaram 15 sessões de 40 minutos de fisioterapia motora, duas vezes por semana. No grupo de intervenção, a fisioterapia foi associada a prática mental (15 minutos). Em relação às variáveis de desfecho primário, o tempo de execução do timed up and go e do teste de caminhada de 10 metros reduziu, mas a diferença não foi significativa. Em relação à velocidade, cadência e escore do dynamic gait index, houve aumento após a intervenção no grupo experimental, com diferença significativa (p=0,02). O número de passos foi mantido em ambos os grupos. Os resultados sugerem que a prática mental associada à fisioterapia motora reduz o risco de quedas em comparação com a fisioterapia motora aplicada isoladamente.
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Gandola M, Zapparoli L, Saetta G, De Santis A, Zerbi A, Banfi G, Sansone V, Bruno M, Paulesu E. Thumbs up: Imagined hand movements counteract the adverse effects of post-surgical hand immobilization. Clinical, behavioral, and fMRI longitudinal observations. NEUROIMAGE-CLINICAL 2019; 23:101838. [PMID: 31071593 PMCID: PMC6506638 DOI: 10.1016/j.nicl.2019.101838] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 04/08/2019] [Accepted: 04/24/2019] [Indexed: 01/05/2023]
Abstract
Motor imagery (M.I.) training has been widely used to enhance motor behavior. To characterize the neural foundations of its rehabilitative effects in a pathological population we studied twenty-two patients with rhizarthrosis, a chronic degenerative articular disease in which thumb-to-fingers opposition becomes difficult due to increasing pain while the brain is typically intact. Before and after surgery, patients underwent behavioral tests to measure pain and motor performance and fMRI measurements of brain motor activity. After surgery, the affected hand was immobilized, and patients were enrolled in a M.I. training. The sample was split in those who had a high compliance with the program of scheduled exercises (T+, average compliance: 84%) and those with low compliance (T−, average compliance: 20%; cut-off point: 55%). We found that more intense M.I. training counteracts the adverse effects of immobilization reducing pain and expediting motor recovery. fMRI data from the post-surgery session showed that T+ patients had decreased brain activation in the premotor cortex and the supplementary motor area (SMA); meanwhile, for the same movements, the T− patients exhibited a reversed pattern. Furthermore, in the post-surgery fMRI session, pain intensity was correlated with activity in the ipsilateral precentral gyrus and, notably, in the insular cortex, a node of the pain matrix. These findings indicate that the motor simulations of M.I. have a facilitative effect on recovery by cortical plasticity mechanisms and optimization of motor control, thereby establishing the rationale for incorporating the systematic use of M.I. into standard rehabilitation for the management of post-immobilization syndromes characteristic of hand surgery. Motor imagery training counteracts the effects of post-surgical hand immobilization. It also reduces pain and expedites motor recovery after immobilization. These effects were accompanied by significant fMRI signs of brain plasticity. The clinical-fMRI evidence advocates for the use of motor imagery in rehabilitation.
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Affiliation(s)
- Martina Gandola
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
| | | | - Gianluca Saetta
- Neuropsychology Unit, Department of Neurology, University Hospital Zurich, Zurich, Switzerland
| | | | | | - Giuseppe Banfi
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Valerio Sansone
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy; University of Milano-Statale, Milan, Italy
| | | | - Eraldo Paulesu
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy; Department of Psychology and Milan Center for Neuroscience (NeuroMI), University of Milano-Bicocca, Milan, Italy.
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Bek J, Gowen E, Vogt S, Crawford TJ, Poliakoff E. Combined action observation and motor imagery influences hand movement amplitude in Parkinson's disease. Parkinsonism Relat Disord 2019; 61:126-131. [DOI: 10.1016/j.parkreldis.2018.11.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 07/14/2018] [Accepted: 11/01/2018] [Indexed: 12/13/2022]
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The use of motor imagery training to retain the performance improvement following physical practice in the elderly. Exp Brain Res 2019; 237:1375-1382. [PMID: 30877341 DOI: 10.1007/s00221-019-05514-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 03/09/2019] [Indexed: 01/01/2023]
Abstract
With physiological aging, appears a deterioration of the ability to retain motor skills newly acquired. In this study, we tested the beneficial role of motor imagery training to compensate this deterioration. We tested four groups: young control group (n = 10), elderly control group (n = 10), young mental-training group (n = 13) and elderly mental-training group (n = 13). In pre- and post-tests, the participants performed three trials on a dexterity manual task (the Nine Hole Peg Test), commonly used in clinic. We recorded the movement duration as a factor of performance. Each trial, including 36 arm movements, consisted in manipulating sticks as fast as possible. The control groups watched a non-emotional documentary for 30 min and the mental-training groups imagined the task (50 trials). First, we observed a speed improvement during the pre-test session for all groups. Immediately after viewing the movie (post-test 1), the young control group showed a preservation of motor performance in comparison to the performance measured before the break (pret-test 3), while the young mental-training group improved performance after motor imagery practice. For the elderly, the control group showed a deterioration of motor performance at post-test 1, attesting a deterioration of the ability to retain motor skills with aging. Interestingly, the elderly mental-training group showed a preservation of motor performance between the pre-test 3 and the post-test 1. The present findings demonstrate the beneficial role of mental training with motor imagery to retain the performance improvement following physical practice in the elderly. This method could be an alternative to prevent the deterioration of motor skills.
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Abraham A, Hart A, Dickstein R, Hackney ME. "Will you draw me a pelvis?ˮ Dynamic neuro-cognitive imagery improves pelvic schema and graphic-metric representation in people with Parkinson's Disease: A randomized controlled trial. Complement Ther Med 2019; 43:28-35. [PMID: 30935544 DOI: 10.1016/j.ctim.2018.11.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 10/29/2018] [Accepted: 11/21/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Body schema (i.e., the mental representations of the body), vital for motor and cognitive functions, is often distorted in people with Parkinson's disease (PD). Deficits in body, and especially pelvic, schema can further exacerbate motor and cognitive deficits associated with PD. Such deficits, including those in graphic and metric misjudgments, can manifest in drawing tasks. Mental imagery is a recommended approach for PD rehabilitation with potential for ameliorating body schema. OBJECTIVE To investigate the effect of a two-week dynamic neuro-cognitive imagery (DNI) training versus in-home learning and exercise control (learning/exercise) on pelvic schema and graphic representation (i.e., drawing height and width). DESIGN Twenty participants with idiopathic PD (Hoehn&Yahr I-III; M age: 65.75 ± 10.13) were randomly allocated into either a DNI or a learning/exercise group. Participants were asked to complete the "Draw Your Pelvisˮ test in which they drew their pelvis at pre- and post-intervention. Drawings were assessed for pelvic schema score and drawing dimensions (i.e., height and weight). INTERVENTION DNI anatomical and metaphorical imagery focusing on pelvic anatomy and biomechanics. RESULTS No difference (p > .05) was detected at baseline between drawn pelvis height and width. Following intervention, improvements were greater in the DNI group for pelvic schema (p < .01), drawn pelvic width (p < .05) and width-height difference (p < .05). CONCLUSIONS This study suggests that DNI could serve as a rehabilitation path for improving body schema in people with PD. Future studies should explore DNI mechanisms of effect and the effect of enhanced pelvic schema on motor and non-motor deficits in this population.
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Affiliation(s)
- Amit Abraham
- Department of Medicine, Division of General Medicine and Geriatrics, Emory University School of Medicine, Atlanta, Georgia, USA; Department of Kinesiology, University of Georgia, Athens, Georgia, USA.
| | - Ariel Hart
- Department of Medicine, Division of General Medicine and Geriatrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Ruth Dickstein
- Department of Physical Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Madeleine E Hackney
- Department of Medicine, Division of General Medicine and Geriatrics, Emory University School of Medicine, Atlanta, Georgia, USA; Atlanta Department of Veterans Affairs Center for Visual and Neurocognitive Rehabilitation, Atlanta, Georgia, USA
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Tinaz S, Para K, Vives-Rodriguez A, Martinez-Kaigi V, Nalamada K, Sezgin M, Scheinost D, Hampson M, Louis ED, Constable RT. Insula as the Interface Between Body Awareness and Movement: A Neurofeedback-Guided Kinesthetic Motor Imagery Study in Parkinson's Disease. Front Hum Neurosci 2018; 12:496. [PMID: 30581383 PMCID: PMC6292989 DOI: 10.3389/fnhum.2018.00496] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 11/26/2018] [Indexed: 11/13/2022] Open
Abstract
Intentional movement is an internally driven process that requires the integration of motivational and sensory cues with motor preparedness. In addition to the motor cortical-basal ganglia circuits, the limbic circuits are also involved in the integration of these cues. Individuals with Parkinson's disease (PD) have a particular difficulty with internally generating intentional movements and maintaining the speed, size, and vigor of movements. This difficulty improves when they are provided with external cues suggesting that there is a problem with the internal motivation of movement in PD. The prevailing view attributes this difficulty in PD to the dysfunction of motor cortical-basal ganglia circuits. First, we argue that the standard cortical-basal ganglia circuit model of motor dysfunction in PD needs to be expanded to include the insula which is a major hub within the limbic circuits. We propose a neural circuit model highlighting the interaction between the insula and dorsomedial frontal cortex which is involved in generating intentional movements. The insula processes a wide range of sensory signals arising from the body and integrates them with the emotional and motivational context. In doing so, it provides the impetus to the dorsomedial frontal cortex to initiate and sustain movement. Second, we present the results of our proof-of-concept experiment demonstrating that the functional connectivity of the insula-dorsomedial frontal cortex circuit can be enhanced with neurofeedback-guided kinesthetic motor imagery using functional magnetic resonance imaging in subjects with PD. Specifically, we found that the intensity and quality of body sensations evoked during motor imagery and the emotional and motivational context of motor imagery determined the direction (i.e., negative or positive) of the insula-dorsomedial frontal cortex functional connectivity. After 10-12 neurofeedback sessions and "off-line" practice of the successful motor imagery strategies all subjects showed a significant increase in the insula-dorsomedial frontal cortex functional connectivity. Finally, we discuss the implications of these results regarding motor function in patients with PD and propose suggestions for future studies.
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Affiliation(s)
- Sule Tinaz
- Division of Movement Disorders, Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT, United States
| | - Kiran Para
- Division of Movement Disorders, Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT, United States
| | - Ana Vives-Rodriguez
- Division of Movement Disorders, Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT, United States
| | - Valeria Martinez-Kaigi
- Division of Movement Disorders, Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT, United States
| | - Keerthana Nalamada
- Division of Movement Disorders, Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT, United States
| | - Mine Sezgin
- Division of Movement Disorders, Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT, United States
- Department of Neurology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Dustin Scheinost
- Department of Radiology & Biomedical Imaging, Yale School of Medicine, Yale University, New Haven, CT, United States
| | - Michelle Hampson
- Department of Radiology & Biomedical Imaging, Yale School of Medicine, Yale University, New Haven, CT, United States
| | - Elan D. Louis
- Division of Movement Disorders, Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT, United States
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, CT, United States
- Center for Neuroepidemiology and Clinical Neurological Research, Yale School of Medicine, Yale University, New Haven, CT, United States
| | - R. Todd Constable
- Department of Radiology & Biomedical Imaging, Yale School of Medicine, Yale University, New Haven, CT, United States
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Paravlic AH, Slimani M, Tod D, Marusic U, Milanovic Z, Pisot R. Effects and Dose-Response Relationships of Motor Imagery Practice on Strength Development in Healthy Adult Populations: a Systematic Review and Meta-analysis. Sports Med 2018. [PMID: 29541965 DOI: 10.1007/s40279-018-0874-8] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Motor imagery (MI), a mental simulation of a movement without overt muscle contraction, has been largely used to improve general motor tasks. However, the effects of MI practice on maximal voluntary strength (MVS) remain equivocal. OBJECTIVES The aims of this meta-analysis were to (1) estimate whether MI practice intervention can meaningfully improve MVS in healthy adults; (2) compare the effects of MI practice on MVS with its combination with physical practice (MI-C), and with physical practice (PP) training alone; and (3) investigate the dose-response relationships of MI practice. DATA SOURCES AND STUDY ELIGIBILITY Seven electronic databases were searched up to April 2017. Initially 717 studies were identified; however, after evaluation of the study characteristics, data from 13 articles involving 370 participants were extracted. The meta-analysis was completed on MVS as the primary parameter. In addition, parameters associated with training volume, training intensity, and time spent training were used to investigate dose-response relationships. RESULTS MI practice moderately improved MVS. When compared to conventional PP, effects were of small benefit in favour of PP. MI-C when compared to PP showed unclear effects. MI practice produced moderate effects in both upper and lower extremities on MVS. The cortical representation area of the involved muscles did not modify the effects. Meta-regression analysis revealed that (a) a training period of 4 weeks, (b) a frequency of three times per week, (c) two to three sets per single session, (d) 25 repetitions per single set, and (e) single session duration of 15 min were associated with enhanced improvements in muscle strength following MI practice. Similar dose-response relationships were observed following MI and PP. CONCLUSIONS The present meta-analysis demonstrates that compared to a no-exercise control group of healthy adults, MI practice increases MVS, but less than PP. These findings suggest that MI practice could be considered as a substitute or additional training tool to preserve muscle function when athletes are not exposed to maximal training intensities.
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Affiliation(s)
- Armin H Paravlic
- Science and Research Centre, Institute for Kinesiology Research, University of Primorska, Garibaldijeva 1, 6000, Koper, Slovenia.
| | - Maamer Slimani
- Research Laboratory "Sports Performance Optimization", National Center of Medicine and Science in Sports (CNMSS), Tunis, Tunisia
| | - David Tod
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Uros Marusic
- Science and Research Centre, Institute for Kinesiology Research, University of Primorska, Garibaldijeva 1, 6000, Koper, Slovenia.,Department of Health Sciences, Alma Mater Europaea - ECM, Maribor, Slovenia
| | - Zoran Milanovic
- Science and Research Centre, Institute for Kinesiology Research, University of Primorska, Garibaldijeva 1, 6000, Koper, Slovenia.,Faculty of Sport and Physical Education, University of Niš, Čarnojevićeva 10a, Niš, 18000, Serbia
| | - Rado Pisot
- Science and Research Centre, Institute for Kinesiology Research, University of Primorska, Garibaldijeva 1, 6000, Koper, Slovenia
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Park J, Cohen I. Effects of Exercise Interventions in Older Adults with Various Types of Dementia: Systematic Review. ACTIVITIES, ADAPTATION & AGING 2018. [DOI: 10.1080/01924788.2018.1493897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Juyoung Park
- Phyllis and Harvey Sandler School of Social Work, Florida Atlantic University, Boca Raton, Florida, USA
| | - Iris Cohen
- Phyllis and Harvey Sandler School of Social Work, Florida Atlantic University, Boca Raton, Florida, USA
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