Effects of Gait Rehabilitation With Motor Imagery in People With Parkinson's Disease

NCT04788693 | Not Yet Recruiting DMC

• 1 other identifier: 1557673
• Study Type: interventional
• Target: 74
• Locations: 1 country
• Sites: 1

Brief Summary

This study aims to determine whether gait physiotherapy combined with motor imagery exercises has a superior effect than gait physiotherapy without motor imagery in people with Parkinson's disease. To do this, a six-week training program will be carried out twice a week, where walking exercises and motor imaging will be performed in the experimental group while walking exercises only, will be conducted in the control group. Motor imagery exercises consist of developing a mental exercise by which an individual rehearses or simulates a given action. We hypothesize that participants who perform motor imagery exercises have better results than participants who train without imagery exercises. To analyze the effect of the programs will be assess the gait, the functionality in activities of daily living, the motor capacity, and the perception of the quality of life of the participants.

Conditions

Parkinson Disease

Keywords

Gait rehabilitation; Motor imagery; Biomechanics of gait; Parkinson's disease

Outcome Measures

Primary Outcomes (1)

• Gait velocity at the post-training time (primary time point)

  Distance traveled by the body per unit of time at self-selected or comfortable speed, in the direction considered. It is expressed in meters per second (m / s).

  6 weeks

Secondary Outcomes (26)

• Gait speed variability

  6 weeks

• Maximum gait speed

  6 weeks

• Stance time

  6 weeks

• Weight-acceptance Ground Reaction Force (Newton, N; Weight%)

  6 weeks

• Midstance Ground Reaction Force (Newton, N; Weight%)

  6 weeks

Study Arms (2)

Motor imagery and gait training group

EXPERIMENTAL

Gait training twice a week for six weeks. Each rehabilitation session is composed of an initial 5 minutes of warm-up exercises (general mobility, coordination, strength, flexibility, balance, and breathing), followed by 45 minutes of gait training with motor imagery exercises and a final 10 minutes of muscle stretching. In the central 45 minutes of the session, exercises will be developed to improve objective characteristics of the gait-related to spatiotemporal and kinematic parameters. Objective and subjective feedback will be used for each exercise (cues). In an interspersed way, motor imagery exercises will be carried out where participants must rehearse or simulate mentally each gait exercise that will be developed in the session.

Other: Physical rehabilitation of gait with motor imagery

Gait training group without motor imagery

ACTIVE COMPARATOR

Gait training twice a week for six weeks. Each rehabilitation session is composed of an initial 5 minutes of warm-up exercises (general mobility, coordination, strength, flexibility, balance, and breathing), followed by 45 minutes of gait training with motor imagery exercises and a final 10 minutes of muscle stretching. In the central 45 minutes of the session, exercises will be developed to improve objective characteristics of the gait-related to spatiotemporal and kinematic parameters. Objective and subjective feedback will be used for each exercise (cues). In the periods that the experimental group performs the motor imagery exercises, the control group will take breaks.

Other: Physical rehabilitation of gait without motor imagery

Interventions

Physical rehabilitation of gait with motor imagery OTHER

Physical rehabilitation of gait is a type of non-invasive treatment that seeks to change the way of performing a task or motor function (in this case, gait) through movement modification and corrected repeated practice, taking into account the alterations, limitations and considerations related to the disease suffered by the person. In this intervention, in addition to physical exercise to correct gait, mental exercises will be included in which the patient visualizes himself performing the exercises that he will then develop with the body.

Also known as: GAITimagery program

Motor imagery and gait training group

Physical rehabilitation of gait without motor imagery OTHER

Physical rehabilitation of gait is a type of non-invasive treatment that seeks to change the way of performing a task or motor function (in this case, gait) through movement modification and corrected repeated practice, taking into account the alterations, limitations and considerations related to the disease suffered by the person. Motor imagery exercises are not included in this program.

Also known as: Gait physiotherapy program

Gait training group without motor imagery

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Diagnosed with PD according to the United Kingdom Parkinson's Disease Society Brain Bank diagnostic scale
• Independent walk in a 10-meter corridor
• Normal cognitive state, determined by the Mini-Mental State Examination with a score \>25
• Stable medication from the month before the start of the study until the t2 assessment.

You may not qualify if:

• Additional neurological condition different from PD
• Disease or musculoskeletal acute alteration that limits mobility or balance
• Lower extremities asymmetries \>1 cm
• Report pain on the Visual Analog Scale
• Suffer from blindness, deafness, or any other visual/hearing impairment or pathology that may influence the ability to understand instructions and carry them out
• Significant tremor that may interrupt the MI exercise
• To perform other physical therapies or sports during the trial or the two months before.

Sponsors & Collaborators

• University of Valencia: lead
• Asociación Parkinson Valencia: collaborator

Study Sites (1)

University of Valencia

Valencia, 46010, Spain

Location

Related Publications (14)

• Leocadi M, Canu E, Sarasso E, Gardoni A, Basaia S, Calderaro D, Castelnovo V, Volonte MA, Filippi M, Agosta F. Dual-task gait training improves cognition and resting-state functional connectivity in Parkinson's disease with postural instability and gait disorders. J Neurol. 2024 Apr;271(4):2031-2041. doi: 10.1007/s00415-023-12151-w. Epub 2024 Jan 8.

  PMID: 38189921 BACKGROUND

• Sarasso E, Gardoni A, Zenere L, Canu E, Basaia S, Pelosin E, Volonte MA, Filippi M, Agosta F. Action observation and motor imagery improve motor imagery abilities in patients with Parkinson's disease - A functional MRI study. Parkinsonism Relat Disord. 2023 Nov;116:105858. doi: 10.1016/j.parkreldis.2023.105858. Epub 2023 Sep 22.

  PMID: 37774517 BACKGROUND

• Sarasso E, Agosta F, Piramide N, Gardoni A, Canu E, Leocadi M, Castelnovo V, Basaia S, Tettamanti A, Volonte MA, Filippi M. Action Observation and Motor Imagery Improve Dual Task in Parkinson's Disease: A Clinical/fMRI Study. Mov Disord. 2021 Nov;36(11):2569-2582. doi: 10.1002/mds.28717. Epub 2021 Jul 19.

  PMID: 34286884 BACKGROUND

• Kashif M, Ahmad A, Bandpei MAM, Gilani SA, Hanif A, Iram H. Combined effects of virtual reality techniques and motor imagery on balance, motor function and activities of daily living in patients with Parkinson's disease: a randomized controlled trial. BMC Geriatr. 2022 Apr 30;22(1):381. doi: 10.1186/s12877-022-03035-1.

  PMID: 35488213 BACKGROUND

• Kashif M, Ahmad A, Bandpei MAM, Gillani SA, Hanif A, Iram H. Effects of Virtual Reality with Motor Imagery Techniques in Patients with Parkinson's Disease: Study Protocol for a Randomized Controlled Trial. Neurodegener Dis. 2020;20(2-3):90-96. doi: 10.1159/000511916. Epub 2020 Dec 17.

  PMID: 33333508 BACKGROUND

• 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. doi: 10.1016/j.nicl.2022.102980. Epub 2022 Mar 2.

  PMID: 35247729 BACKGROUND

• Santiago LM, de Oliveira DA, de Macedo 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. doi: 10.3233/NRE-151259.

  PMID: 26484518 BACKGROUND

• Scarpina F, Magnani FG, Tagini S, Priano L, Mauro A, Sedda A. Mental representation of the body in action in Parkinson's disease. Exp Brain Res. 2019 Oct;237(10):2505-2521. doi: 10.1007/s00221-019-05608-w. Epub 2019 Jul 20.

  PMID: 31327026 BACKGROUND

• 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. doi: 10.1016/S1836-9553(11)70004-2.

  PMID: 21402327 BACKGROUND

• Bek J, Webb J, Gowen E, Vogt S, Crawford TJ, Sullivan MS, Poliakoff E. Patients' Views on a Combined Action Observation and Motor Imagery Intervention for Parkinson's Disease. Parkinsons Dis. 2016;2016:7047910. doi: 10.1155/2016/7047910. Epub 2016 Sep 29.

  PMID: 27777809 BACKGROUND

• 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 Apr;61:126-131. doi: 10.1016/j.parkreldis.2018.11.001. Epub 2018 Nov 9. No abstract available.

  PMID: 30470657 BACKGROUND

• Subramanian L, Morris MB, Brosnan M, Turner DL, Morris HR, Linden DE. Functional Magnetic Resonance Imaging Neurofeedback-guided Motor Imagery Training and Motor Training for Parkinson's Disease: Randomized Trial. Front Behav Neurosci. 2016 Jun 8;10:111. doi: 10.3389/fnbeh.2016.00111. eCollection 2016.

  PMID: 27375451 BACKGROUND

• 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 Oct;58(5):715-722. doi: 10.23736/S1973-9087.22.07313-0. Epub 2022 Sep 1.

  PMID: 36052889 BACKGROUND

• 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 Jan-Feb;21(1):68-75. doi: 10.1177/1545968306292608.

  PMID: 17172556 BACKGROUND

MeSH Terms

Conditions

Parkinson Disease

Condition Hierarchy (Ancestors)

Parkinsonian Disorders; Basal Ganglia Diseases; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Movement Disorders; Synucleinopathies; Neurodegenerative Diseases

Study Officials

• Constanza San Martín, PhD.

  Associate Lecturer professor at the Department of Physiotherapy

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Constanza San Martín, PhD.

CONTACT

963864768; constanza.martin@uv.es

Luz Sánchez, PhD.

CONTACT

963983853; M.Luz.Sanchez@uv.es

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: INVESTIGATOR, OUTCOMES ASSESSOR
• Masking Details: To ensure masking, the raters physiotherapist, and data analysis researcher, will be blinded to the participant's allocation. Although participants and treating physiotherapists cannot be totally blinded to the intervention performed, the hypothesis and objectives of the study will be hidden from them. At the same time, all participants will be instructed not to disclose information regarding their intervention to the raters' physiotherapists.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Lecturer professor at the Department of Physiotherapy

Study Record Dates

• First Submitted: March 1, 2021
• First Posted: March 9, 2021
• Study Start: September 1, 2025
• Primary Completion (Estimated): December 1, 2026
• Study Completion (Estimated): December 1, 2026
• Last Updated: October 15, 2024

Record last verified: 2024-10

Data Sharing

• IPD Sharing: Will not share

Locations

ES (1)