Effects of mental practice strategies associated with physical therapy on gait and risk of falls in Parkinson disease: experimental study

Abstract

Objective: To compare the effects of mental practice (MP) strategies associated with physical therapy on gait and risk of falls in people with Parkinson's disease (PD). Method: We included 35 people of both sexes with mild to moderate idiopathic PD allocated into four groups; 1- Control group (CG), 2- Image-guided mental practice group (IGMP), 3- Audio-guided mental practice group (AGMP) and 4- Unguided mental practice group (UMP). The subjects in the experimental groups underwent 15 sessions of motor physical therapy and mental practice, while the CG received only physical therapy. The sessions were held twice a week, 40 minutes for motor physical therapy and 1 minutes for the corresponding Mental Practice protocol. To evaluate the spatiotemporal parameters of the gait, the 10-meter Walking Test was used and the risk of falls using the Timed Up and Go (TUG). Results: The IGPM group presented significant results for the time (p= 0.027) and gait speed (p= 0.025) when compared to the results of the CG. Cadence and risk of falls had no major effect for the group. The UMP and AGMP groups did not present statistically significant results for TC10m and TUG when compared with CG. Conclusion: The results of this study suggest that image-guided mental practice training associated with motor physical therapy is more effective in increasing gait speed than other MP strategies.

Effectiveness of Motor Imagery in the Rehabilitation of People With Parkinson’s Disease: A Systematic Review and Meta-Analysis

“…Eleven of the 13 articles were considered to have good methodological quality. 10,25,27,28,[30][31][32][33][34][35][36] All articles scored 0 in items 5 and 6 (participant and therapist blinding).…”

“…The electronic search of the databases led to the retrieval of 1,073 publications (Figure 1). Thirteen articles were selected, [25][26][27][28][29][30][31][32][33][34][35][36] involving a total of 320 PwPD (163 in experimental groups, 157 in control groups). No additional articles were found through hand searching of the reference list of included articles.…”

“…Seven of the studies included a physiotherapy protocol in the intervention. 10,25,27,28,30,31,34 One included cognitive remediation therapy, 29 1 involved MI training using attention to compensate for movement difficulties, 32 1 included neurofeedback, 36 and 1 involved dual tasks. 35 The duration and frequency of the sessions ranged from 30 to 120 minutes and from 1 to 5 times per week.…”

“…Body structure and function were evaluated in 10 articles (9 studies), 10,26,[29][30][31][32][33][34][35][36] and activity and participation were also evaluated in 10 articles (Table 2). 10,[25][26][27][28][30][31][32]35,36 For the body structure and function outcome category, cognition was evaluated most (in 6 articles), 26,29,33,35,36 followed by gait and leg endurance (5 articles) 26,30,[34][35][36] and dynamic balance (4 articles). 10,26,32,35 In the activity and participation outcome category, functional mobility was evaluated in 10 out of the 13 selected articles.…”

“…10,26,32,35 In the activity and participation outcome category, functional mobility was evaluated in 10 out of the 13 selected articles. The most commonly reported outcome measures used were the TUG, 10,[26][27][28][30][31][32]35 UPDRS, 26,32,35 and 10 m walk test (10MWT). 10,27,28,32,35,36 Comparing the experimental and control groups, 9 articles reported significantly better improvement in the experimental group in at least 1 component of body structure and function evaluated.…”