Patients’ Views on a Combined Action Observation and Motor Imagery Intervention for Parkinson’s Disease

Abstract

Background. Action observation and motor imagery activate neural structures involved in action execution, thereby facilitating movement and learning. Although some benefits of action observation and motor imagery have been reported in Parkinson's disease (PD), methods have been based on stroke rehabilitation and may be less suitable for PD. Moreover, previous studies have focused on either observation or imagery, yet combining these enhances effects in healthy participants. The present study explores the feasibility of a PD-specific home-based intervention combining observation, imagery, and imitation of meaningful everyday actions. Methods. A focus group was conducted with six people with mild to moderate PD and two companions, exploring topics relating to the utility and feasibility of a home-based observation and imagery intervention. Results. Five themes were identified. Participants reported their experiences of exercise and use of action observation and motor imagery in everyday activities, and the need for strategies to improve movement was expressed. Motivational factors including feedback, challenge, and social support were identified as key issues. The importance of offering a broad range of actions and flexible training was also highlighted. Conclusions. A home-based intervention utilising action observation and motor imagery would be useful and feasible in mild to moderate PD.

Action observation produces motor resonance in Parkinson's disease

“…In particular , it has been proposed that impaired social‐perceptive processing in PD may be related to dysfunction of the mirror neuron system (Alegre et al ., ); however, our results suggest that activation of this system in people with mild‐to‐moderate PD is similar to that of healthy older adults. Additionally, people with PD report engaging in behavioural mimicry in social situations (e.g., mirroring a partner's hand gestures; Bek et al ., ), and show appropriate spontaneous facial expressions in response to emotional and social context (Simons, Pasqualini, Reddy, & Wood, ). Nevertheless, because of a general reduction in spontaneous actions, overt signs of motor resonance may be less apparent in PD.…”

Action Imagery and Observation in Neurorehabilitation for Parkinson’s Disease (ACTION-PD): development and pilot randomised controlled trial of a user-informed home training intervention to improve everyday functional actions

“…Given the heterogeneous nature of PD, "personalised treatments" has been identified as a research priority by people with PD [8] to address the broad range of everyday activities that individuals may find difficult (e.g., [7]). In this respect, training based on action representation (AO and MI) can be tailored to the individual's needs and rehabilitation goals.…”

“…The feasibility of other home interventions using digital technology in PD has been reported, such as "exergame" activities focused on movement timing and coordination (e.g., [55,56]), and if effective, this approach could provide a widely accessible, low-cost alternative or supplement to existing rehabilitation programmes. A previous focus group with people with PD [7] explored views on the proposed ACTION-PD intervention, as well as individuals' understanding and experiences of AO and MI. The focus group indicated that a home-based combined AO+MI intervention would be acceptable and useful for people with mild to moderate PD.…”

“…An action library was first compiled to enable users to select the actions they wished to train: actions were identified from suggestions provided in the previous focus group [7], as well as examination of the literature and discussions within the research team. The selection of actions was limited to those that could be practiced safely at home in a seated position, using everyday objects.…”

“…Daily activities can be affected even in the early stages of PD [4], potentially impacting on work performance as well as household tasks, self-care, hobbies and leisure activities; thereby significantly limiting independence and quality of life. Indeed, people with PD consistently report dexterity among the domains most affected by the condition [5,6], and have expressed a need for interventions to improve dexterity [7,8]. However, few studies have directly addressed dexterity problems in PD [9].…”