Exploring Motor Imagery as a Therapeutic Intervention for Parkinson’s Disease Patients: A Scoping Review

Abstract

AbstractBackgroundMotor Imagery (MI) has emerged as a promising therapeutic approach in the rehabilitation of individuals with Parkinson’s Disease (PD). MI entails mentally rehearsing motor actions without physically executing them. This cognitive process has garnered attention due to its potential benefits in aiding motor function recovery in PD patients. Its role in complementing traditional treatment approaches is likely to reverberate throughout clinical practice. This study strives to provide a comprehensive examination several MI protocols designed for individuals with PD. The focus was to underscore the outcomes observed across motor symptoms, balance, gait, and quality of life.MethodsA literature search was carried out in the following databases: Medline, Embase, Cochrane, and PEDro, from the first publication to February 2024. Study with at least one keyword in relation to PD and MI in the title were included.ResultsOf the 262 studies 53 were included. Twelve RCTs with a mean PEDro score of 6.6/10 and 41 descriptive and non-RCT studies. Among the RCTs, there were almost exclusively MI on balance, gait, and lower limbs exercise. They found an 85.2% improvement for the experimental group on the TUG with a cognitive task (p<0.02), 5.8% on the TUG (p<0.05), a 5.1% improvement in walking speed (p<0.05), other variables did not show significant improvement. For the descriptive and non-RCTs studies, there were various tasks and outcomes for the lower and upper limbs. It was shown that there was no difference in execution time in MI between patients with PD and HS, while in ME patients with PD were slower. For the upper limb, several tasks were proposed, such as thumb opposition, joystick movements and writing tasks with variable results. RCTs were more focused on balance, lower limb and walking, there was no specific outcome for the upper limb and speech. The heterogeneity of the tasks and outcomes across all included studies is also a limitation.ConclusionTo summarize, the current research on walking disorders in PD shows promise, but further investigations are crucial, particularly with an emphasis on upper limb function and speech. A need exists for studies with larger sample sizes, utilizing precise methodologies, and specifically targeting these areas to enhance our comprehension of the potential advantages of MI in the context of comprehensive PD rehabilitation.