Effects of Motor Imagery Training

Condition(s) studied

Investigational drug(s) / intervention(s)

Mental Imagery Application Protocol: Before the GYKO test, the patient will be asked to perform mental imagery to visualize a 3-meter distance for five cycles, and the time will be recorded. The TKYT will be administered according to standard protocols. Mental Imagery Application Protocol: 1. Awareness: The therapist will show a video of a typical normal gait for an adult male or female without pathology and compare it with a video of the patient's own gait. 2. Problem Identification/Explanation In the EG, subjects will identify gait problems and compare their gait with their typical gait. They will then use the comparative information for feedback. 3. Progressive Relaxation 4. Mental Imagery of Gait 5. Physıcal Performance Of The gait This protocol will be implemented the day after the initial assessment and will be conducted in 12 training sessions of no more than 90 minutes, three times per week for 4 weeks.

Study summary

Parkinson's disease (PD) is the second most common neurodegenerative disease, characterized pathologically by the progressive loss of dopaminergic neurons in the substantia nigra and clinically by the presence of motor symptoms such as bradykinesia, resting tremor, and/or rigidity. Among the motor deficits frequently observed in PD, patients are known to frequently report difficulties with manual dexterity.Typical features of balance deficits in PD include decreased sway, decreased base of support, rigidity, abnormal intersegmental coordination, and postural misalignment. Related somatosensory deficits in PD include problems orienting to and processing sensory and somatosensory information.Motor imagery (MI) is the imaginal execution of motor activities or the activation of specific muscles in the absence of any explicit feedback. This area of rehabilitation has been shown to be effective in improving and developing motor skills in many neurological conditions where patients exhibit motor recognition and execution impairments. MI can be applied at all stages of recovery from PD, is highly effective in movement-related pathologies, and can be performed independently.Studies evaluating the effect of mental imagery training on balance measures in PD are limited. One study evaluating the effect of combined MI-physical therapy versus physical therapy alone group treatment noted positive trends toward balance improvements in the combined group. In a case study of a single participant with PD, a 3-month neurocognitive rehabilitation program incorporating mental imagery over 20 sessions resulted in balance improvements and a reduced risk of falls in both the "OFF" and "ON" phases, as measured by the Tinetti Balance and Gait Assessment Scale.The aim of this study is to investigate the effects of motor imagery training on kinesiophobia, walking and balance in patients with Parkinson's disease.

Eligibility

Primary outcome measure(s)

• Mental Chronometry with Timed up Go Test and Gyko device — first day of the assessment and after the end of the treatment protocol (in the 5th week of the assessment) .
  Mental chronometry is a method considered more objective than questionnaires in the assessment of MI, measuring imagery time. In other words, it examines the time difference between the actual physical execution of a movement and the mental imagery of the same movement. In the calculated mental chronometry value, a value of zero indicates perfect synchrony between motor imagery and motor execution. Values above zero indicate that the task was performed faster during motor imagery than during motor execution, and values below zero indicate that the task was performed slower during motor imagery than during motor execution. Patients' actual walking times (MIT) and imagery times (MET) are recorded. The difference in time and the mental chronometry ratio are calculated, and the mental chronometry ratio is evaluated using the following formula.In our study, the timed up and go test (TUG) and the gyko test will be used as mental chronometry tests.
• Tampa Kinesiophobia Scale — first day of the assesment and the 5th week of the treatment protocol.
  The Tampa Kinesiophobia Scale (TKS) is a 17-question checklist developed to measure fear of movement and re-injury. Items are scored on a 4-point Likert scale (1: Strongly disagree, 4: Strongly agree). A total score is calculated by reversing items 4, 8, 12, and 16. A person receives a total score between 17 and 68. A total score of 37 points or higher indicates a high level of kinesiophobia. As a participant's score increases, so does the severity of their kinesiophobia. The use of the total score is recommended in studies. A Turkish version of the scale was developed and its reliability study was conducted in 2011.
• The Gyko Device — baseline and the 5th week of the treatment protocol.
  This device, manufactured by Mikrogate and manufactured in Italy, is used as a portable inertial measurement unit for motion analysis and postural stability assessment. The displacement of the center of gravity is analyzed using a computer using a sensor placed on a sling. The patient is asked to walk for 30 seconds.

Trial sites (1)

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