Skip to main content
Top
Published in: Trials 1/2019

Open Access 01-12-2019 | Parkinson's Disease | Study protocol

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

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

Published in: Trials | Issue 1/2019

Login to get access

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.
Appendix
Available only for authorised users
Literature
1.
go back to reference Iansek R, Danoudis M, Bradfield N. Gait and cognition in Parkinson’s disease: implications for rehabilitation. Rev Neurosci. 2013;24(3):293–300.CrossRef Iansek R, Danoudis M, Bradfield N. Gait and cognition in Parkinson’s disease: implications for rehabilitation. Rev Neurosci. 2013;24(3):293–300.CrossRef
2.
go back to reference Nieuwboer A, Kwakkel G, Rochester L, et al. Cueing training in the home improves gait-related mobility in Parkinson’s disease: the RESCUE trial. J Neurol Neurosurg Psychiatry. 2007;78:134–40.CrossRef Nieuwboer A, Kwakkel G, Rochester L, et al. Cueing training in the home improves gait-related mobility in Parkinson’s disease: the RESCUE trial. J Neurol Neurosurg Psychiatry. 2007;78:134–40.CrossRef
3.
go back to reference Lim I, Van Wegan E, Jones D, Rochester L, Nieuwboer A, Willems A, et al. Does cueing training improve physical activity in patients with Parkinson’s disease? Neurorehabil Neural Repair. 2010;24(5):469–7727.CrossRef Lim I, Van Wegan E, Jones D, Rochester L, Nieuwboer A, Willems A, et al. Does cueing training improve physical activity in patients with Parkinson’s disease? Neurorehabil Neural Repair. 2010;24(5):469–7727.CrossRef
4.
go back to reference Cohen OS, Vakil E, Tanne D, Molshatzki N, Nitsan Z, Hassin-Baer S. The Frontal Assessment Battery as a tool for evaluation of frontal lobe dysfunction in patients with Parkinson disease. J Geriatr Psychiatry Neurol. 2012;25(2):71–7.CrossRef Cohen OS, Vakil E, Tanne D, Molshatzki N, Nitsan Z, Hassin-Baer S. The Frontal Assessment Battery as a tool for evaluation of frontal lobe dysfunction in patients with Parkinson disease. J Geriatr Psychiatry Neurol. 2012;25(2):71–7.CrossRef
5.
go back to reference Frazzitta G, Maestri R, Uccellini D, Bertotti G, Abelli P. Rehabilitation treatment of gait in patients with Parkinson’s disease with freezing: a comparison between two physical therapy protocols using visual and auditory cues with or without treadmill training. Mov Disord. 2009;24(8):1139–43.CrossRef Frazzitta G, Maestri R, Uccellini D, Bertotti G, Abelli P. Rehabilitation treatment of gait in patients with Parkinson’s disease with freezing: a comparison between two physical therapy protocols using visual and auditory cues with or without treadmill training. Mov Disord. 2009;24(8):1139–43.CrossRef
6.
go back to reference Spaulding SJ, Barber B, Colby M, Cormack B, Mick T, Jenkins ME. Cueing and gait improvement among people with Parkinson’s disease: a meta-analysis. Arch Phys Med Rehabil. 2013;94(3):562–70.CrossRef Spaulding SJ, Barber B, Colby M, Cormack B, Mick T, Jenkins ME. Cueing and gait improvement among people with Parkinson’s disease: a meta-analysis. Arch Phys Med Rehabil. 2013;94(3):562–70.CrossRef
7.
go back to reference Bočková M, Rektor I. Impairment of brain functions in Parkinson’s disease reflected by alterations in neural connectivity in EEG studies: a viewpoint. Clin Neurophysiol. 2019;130(2):239–47.CrossRef Bočková M, Rektor I. Impairment of brain functions in Parkinson’s disease reflected by alterations in neural connectivity in EEG studies: a viewpoint. Clin Neurophysiol. 2019;130(2):239–47.CrossRef
8.
go back to reference De Vries S, Mulder T. Motor imagery and stroke rehabilitation: a critical discussion. J Rehabil Med. 2007;39(1):5–13.CrossRef De Vries S, Mulder T. Motor imagery and stroke rehabilitation: a critical discussion. J Rehabil Med. 2007;39(1):5–13.CrossRef
9.
go back to reference Malouin F, Jackson PL, Richards CL. Towards the integration of mental practice in rehabilitation programs. A critical review. Front Hum Neurosci. 2013;7:576.CrossRef Malouin F, Jackson PL, Richards CL. Towards the integration of mental practice in rehabilitation programs. A critical review. Front Hum Neurosci. 2013;7:576.CrossRef
10.
go back to reference Beisteiner R, Höllinger P, Lindinger G, Lang W, Berthoz A. Mental representations of movements. Brain potentials associated with imagination of hand movements. Electroencephalogr Clin Neurophysiol. 1995;96(2):183–93.CrossRef Beisteiner R, Höllinger P, Lindinger G, Lang W, Berthoz A. Mental representations of movements. Brain potentials associated with imagination of hand movements. Electroencephalogr Clin Neurophysiol. 1995;96(2):183–93.CrossRef
11.
go back to reference Pfurtscheller G, Neuper C. Motor imagery activates primary sensorimotor area in humans. Neurosci Lett. 1997;239:65–8.CrossRef Pfurtscheller G, Neuper C. Motor imagery activates primary sensorimotor area in humans. Neurosci Lett. 1997;239:65–8.CrossRef
12.
go back to reference Snijders AH, Leunissen I, Bakker M, Overeem S, Helmich RC, Bloem BR, et al. Gait-related cerebral alterations in patients with Parkinson’s disease with freezing of gait. Brain. 2011;134:59–72.CrossRef Snijders AH, Leunissen I, Bakker M, Overeem S, Helmich RC, Bloem BR, et al. Gait-related cerebral alterations in patients with Parkinson’s disease with freezing of gait. Brain. 2011;134:59–72.CrossRef
13.
go back to reference Jahn K, Deutschländer A, Stephan T, Kalla R, Wiesmann M, Strupp M, et al. Imaging human supraspinal locomotor centers in brainstem and cerebellum. Neuroimage. 2008;39(2):786–92.CrossRef Jahn K, Deutschländer A, Stephan T, Kalla R, Wiesmann M, Strupp M, et al. Imaging human supraspinal locomotor centers in brainstem and cerebellum. Neuroimage. 2008;39(2):786–92.CrossRef
14.
go back to reference La Fougère C, Zwergal A, Rominger A, Förster S, Fesl G, Dieterich M, et al. Real versus imagined locomotion: a [18F]-FDG PET-fMRI comparison. Neuroimage. 2010;50:1589–98.CrossRef La Fougère C, Zwergal A, Rominger A, Förster S, Fesl G, Dieterich M, et al. Real versus imagined locomotion: a [18F]-FDG PET-fMRI comparison. Neuroimage. 2010;50:1589–98.CrossRef
15.
go back to reference Nilsen DM, Gillen G, Gordon AM. Use of mental practice to improve upper-limb recovery after stroke: a systematic review. Am J Occup Ther. 2010;64(5):695–708.CrossRef Nilsen DM, Gillen G, Gordon AM. Use of mental practice to improve upper-limb recovery after stroke: a systematic review. Am J Occup Ther. 2010;64(5):695–708.CrossRef
17.
go back to reference Tamir R, Dickstein R, Huberman M. Integration of motor imagery and physical practice in group treatment applied to subjects with Parkinson’s disease. Neurorehabil Neural Repair. 2007;21(1):68–75.CrossRef Tamir R, Dickstein R, Huberman M. Integration of motor imagery and physical practice in group treatment applied to subjects with Parkinson’s disease. Neurorehabil Neural Repair. 2007;21(1):68–75.CrossRef
18.
go back to reference El-Wishy AA, Fayez ES. Effect of locomotor imagery training added to physical therapy program on gait performance in Parkinson patients: a randomized controlled study. Egypt J Neurol Psychiatry Neurosurg. 2013;50(1)):31. El-Wishy AA, Fayez ES. Effect of locomotor imagery training added to physical therapy program on gait performance in Parkinson patients: a randomized controlled study. Egypt J Neurol Psychiatry Neurosurg. 2013;50(1)):31.
19.
go back to reference Santiago LM, de Oliveira DA, de Macêdo Ferreira LG, de Brito Pinto HY, Spaniol AP, de Lucena Trigueiro LC, Ribeiro TS, de Sousa AV, Piemonte ME, Lindquist AR. Immediate effects of adding mental practice to physical practice on the gait of individuals with Parkinson’s disease: randomized clinical trial. NeuroRehabilitation. 2015;37(2):263–71.CrossRef Santiago LM, de Oliveira DA, de Macêdo Ferreira LG, de Brito Pinto HY, Spaniol AP, de Lucena Trigueiro LC, Ribeiro TS, de Sousa AV, Piemonte ME, Lindquist AR. Immediate effects of adding mental practice to physical practice on the gait of individuals with Parkinson’s disease: randomized clinical trial. NeuroRehabilitation. 2015;37(2):263–71.CrossRef
20.
go back to reference Braun S, Beurskens A, Kleynen M, Schols J, Wade D. Rehabilitation with mental practice has similar effects on mobility as rehabilitation with relaxation in people with Parkinson’s disease: a multicentre randomised trial. J Physiother. 2011;57(1):27–34.CrossRef Braun S, Beurskens A, Kleynen M, Schols J, Wade D. Rehabilitation with mental practice has similar effects on mobility as rehabilitation with relaxation in people with Parkinson’s disease: a multicentre randomised trial. J Physiother. 2011;57(1):27–34.CrossRef
21.
go back to reference Sullivan KM, Dean A, Soe MM. On academics: OpenEpi: a web-based epidemiologic and statistical calculator for public health. Public Health Rep. 2009;124(3):471–4.CrossRef Sullivan KM, Dean A, Soe MM. On academics: OpenEpi: a web-based epidemiologic and statistical calculator for public health. Public Health Rep. 2009;124(3):471–4.CrossRef
22.
go back to reference Shenkman ML, Clark K, Xie T, Kuchibhatla M, Shinberg M, Ray L. Spinal movement and performance of standing reach task in participants with and without Parkinson disease. Phys Ther. 2001;81:1400–11.CrossRef Shenkman ML, Clark K, Xie T, Kuchibhatla M, Shinberg M, Ray L. Spinal movement and performance of standing reach task in participants with and without Parkinson disease. Phys Ther. 2001;81:1400–11.CrossRef
23.
go back to reference Brucki SMD, Nitrini R, Caramelli P, et al. Sugestões para o uso do Mini exame do estado mental no Brasil. Arq Neuropsiquiatr. 2003;61(3–8):777–81.CrossRef Brucki SMD, Nitrini R, Caramelli P, et al. Sugestões para o uso do Mini exame do estado mental no Brasil. Arq Neuropsiquiatr. 2003;61(3–8):777–81.CrossRef
24.
go back to reference Williams SE, Cumming J, Ntoumanis N, Nordin-Bates SM, Ramsey R, Hall C. Further validation and development of the movement imagery questionnaire. J Sport Exerc Psychol. 2012;34(5):621–46.CrossRef Williams SE, Cumming J, Ntoumanis N, Nordin-Bates SM, Ramsey R, Hall C. Further validation and development of the movement imagery questionnaire. J Sport Exerc Psychol. 2012;34(5):621–46.CrossRef
25.
go back to reference Malachias MVB, Souza WKSB, Plavnik FL, Rodrigues CIS, Brandão AA, Neves MFT, et al. 7ª Diretriz Brasileira de Hipertensão Arterial. Arq Bras Cardiol. 2016;107:3 Suppl 3:1–83. Malachias MVB, Souza WKSB, Plavnik FL, Rodrigues CIS, Brandão AA, Neves MFT, et al. 7ª Diretriz Brasileira de Hipertensão Arterial. Arq Bras Cardiol. 2016;107:3 Suppl 3:1–83.
26.
go back to reference Aspinall P, Mavros P, Coyne R, Roe J. The urban brain: analyzing outdoor physical activity with mobile EEG. Br J Sports Med. 2015;49(4):272–6.CrossRef Aspinall P, Mavros P, Coyne R, Roe J. The urban brain: analyzing outdoor physical activity with mobile EEG. Br J Sports Med. 2015;49(4):272–6.CrossRef
27.
go back to reference Badcock NA, Mousikou P, Mahajan Y, de Lissa P, Thie J, McArthur G. Validation of the Emotiv EPOC® EEG gaming system for measuring research quality auditory ERPs. Peer J. 2013;1:e38.CrossRef Badcock NA, Mousikou P, Mahajan Y, de Lissa P, Thie J, McArthur G. Validation of the Emotiv EPOC® EEG gaming system for measuring research quality auditory ERPs. Peer J. 2013;1:e38.CrossRef
28.
go back to reference Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39:142–8.CrossRef Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39:142–8.CrossRef
Metadata
Title
Effects of motor imagery training of Parkinson's disease: a protocol for a randomized clinical trial
Authors
Isaíra Almeida Pereira da Silva Nascimento
Lorenna Marques de Melo Santiago
Aline Alves de Souza
Camila de Lima Pegado
Tatiana Souza Ribeiro
Ana Raquel Rodrigues Lindquist
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Trials / Issue 1/2019
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-019-3694-8

Other articles of this Issue 1/2019

Trials 1/2019 Go to the issue