ClinicSpeak: physical rehabilitation using your imagination

Never underestimate the power of imagination. #MSResearch #MSBlog #ClinicSpeak

"My brother-in-law who is a petrol head was a major Ayrton Senna fan and had the opportunity of meeting him. He told me that one of the reasons why Senna was so good is that he used motor imagery to practice; in addition to practising out on the track he used to spend hours, and hours, imaging racing on a particular track. He would mentally go through the gear changes, imagining the accelerations, decelerations and driving on and off the racing line. He told my brother-in-law that for every physical lap he practice he would 10 or more imaginary laps and he would vary the laps in his thoughts. He would even practice different overtaking manoeuvres in his mind. He claimed the mental imagery was what gave him the edge. I am, therefore, not surprised that cued motor imagery in relation to walking helps improve walking speed, fatigue and quality of life in MSers. I am not saying this can replace physical exercise, but it can augment it and all you need is a pair of headphones, music and an imagination. Easier said than done?"

Seebacher et al.  The effect of rhythmic-cued motor imagery on walking, fatigue and quality of life in people withmultiple sclerosis: A randomised controlled trial.Mult Scler. 2016 Apr 7. pii: 1352458516644058. [Epub]

BACKGROUND: Motor imagery and rhythmic auditory stimulation are physiotherapy strategies for walking rehabilitation.

OBJECTIVES: To investigate the effect of motor imagery combined with rhythmic cueing on walking, fatigue and quality of life (QoL) in people with multiple sclerosis (MS).

METHODS: Individuals with MS and Expanded Disability Status Scale scores of 1.5-4.5 were randomised into one of three groups: 17 minutes of motor imagery, six times per week, for 4 weeks, with music (A) or metronome cues (B), both with verbal cueing, and (C) controls. Primary outcomes were walking speed (Timed 25-Foot Walk) and distance (6-Minute Walk Test). Secondary outcomes were walking perception (Multiple Sclerosis Walking Scale-12), fatigue (Modified Fatigue Impact Scale) and QoL (Short Form-36 Health Survey, Multiple Sclerosis Impact Scale-29, Euroquol-5D-3L Questionnaire).

RESULTS: Of the 112 participants randomised, 101 completed the study. Compared to controls, both interventions significantly improved walking speed, distance and perception. Significant improvements in cognitive but not psychosocial fatigue were seen in the intervention groups, and physical fatigue improved only in the music-based group. Both interventions improved QoL; however, music-cued motor imagery was superior at improving health-related QoL.

CONCLUSIONS: Rhythmic-cued motor imagery improves walking, fatigue and QoL in people with MS, with music-cued motor imagery being more effective.

Labels: , , , ,