Effects of Motor Imagery Training on Kinesiophobia, Gait, and Balance in Parkinson's Disease Patients
Trial Snapshot
- Phase
- Not Applicable
- Status
- Recruiting
- Sponsor
- Enrollment
- 50
- Locations
- 1
- Primary Endpoint
- Mental Chronometry with Timed up Go Test and Gyko device
Study Overview
Brief 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.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- None
Eligibility Criteria
- Ages
- 40 Years to 75 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Individuals aged 40-75 diagnosed with idiopathic PD, with a Modified Hoehn & Yahr (m-HY) scale stage ≤4, and a score of ≥22 on the Mini Mental State Examination for those with formal training and ≥18 for those without formal training;
- •Individuals with no other known neurological and/or systemic disease;
- •Individuals without any upper extremity contractures;
Exclusion Criteria
- •Individuals with diagnosed and/or treated psychiatric illnesses;
- •Individuals who are taking neuroleptic medications or antidepressants;
- •Individuals with orthopedic conditions such as severe dyskinesia, carpal tunnel syndrome, tendon injuries, and finger amputations that interfere with manual dexterity tests; rheumatological conditions such as rheumatoid arthritis and osteoarthritis; and individuals with any neurological disease other than PD.
Arms & Interventions
study group
'Mental Imagery Application Protocol' will be applied to this group. The timed up and go test (TUG) and gyko test will be used as mental chronometry tests with the patients of parkinson diesase.Therefore, the walking mental imagery protocol will be applied to this group.
Intervention: Mental Imagery Application Protocol (Other)
control group
This group will have routin medical treatment.
Outcomes
Primary Outcomes
Mental Chronometry with Timed up Go Test and Gyko device
Time Frame: 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
Time Frame: 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
Time Frame: 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.
Secondary Outcomes
- Modified Hoehn & Yahr (m-HY) Scale(first day of the assesment and the 5th week of the treatment protocol.)
- sosyodemographic form(first day of the assesment and the 5th week of the treatment protocol.)
- The Kinesthetic and Visual Imagery Questionnaire (KVIQ)-short form(first day of the assesment and 5th week of the treatment protocol.)
- Unified Parkinson's Disease Rating Scale (UPDRS)(first day of the assesment and the 5th week of the treatment protocol.)
- Mini Mental State Examination (MMSE)(first day of the assesment and the 5th week of the treatment protocol.)
Investigators
Hatice Adiguzel
Associate Professor
Kahramanmaras Sutcu Imam University