Motor Imagery Training Group Research Articles

Motor network reorganization after motor imagery training in stroke patients with moderate to severe upper limb impairment.

Motor imagery training (MIT) has been widely used to improve hemiplegic upper limb function in stroke rehabilitation. The effectiveness of MIT is associated with the functional neuroplasticity of the motor network. Currently, brain activation and connectivity changes related to the motor recovery process after MIT are not well understood. We aimed to investigate the neural mechanisms of MIT in stroke rehabilitation through a longitudinal intervention study design with task-based functional magnetic resonance imaging (fMRI) analysis. We recruited 39 stroke patients with moderate to severe upper limb motor impairment and randomly assigned them to either the MIT or control groups. Patients in the MIT group received 4 weeks of MIT therapy plus conventional rehabilitation, while the control group only received conventional rehabilitation. The assessment of Fugl-Meyer Upper Limb Scale (FM-UL) and Barthel Index (BI), and fMRI scanning using a passive hand movement task were conducted on all patients before and after treatment. The changes in brain activation and functional connectivity (FC) were analyzed. Pearson's correlation analysis was conducted to evaluate the association between neural functional changes and motor improvement. The MIT group achieved higher improvements in FM-UL and BI relative to the control group after the treatment. Passive movement of the affected hand evoked an abnormal bilateral activation pattern in both groups before intervention. A significant Group × Time interaction was found in the contralesional S1 and ipsilesional M1, showing a decrease of activation after intervention specifically in the MIT group, which was negatively correlated with the FM-UL improvement. FC analysis of the ipsilesional M1 displayed the motor network reorganization within the ipsilesional hemisphere, which correlated with the motor score changes. MIT could help decrease the compensatory activation at both hemispheres and reshape the FC within the ipsilesional hemisphere along with functional recovery in stroke patients.

Using Motor Imagery as an Alternative to Exercise for Improvement of Mental Health: A Qualitative Investigation

Exercise is a commonly used non-pharmacological treatment to improve the mental and physical health of patients with varying conditions. However, not all patients have the means to participate in exercise and/or physical exertion. Motor imagery training (MIT) is visualizing a task without motor output. Evidence has demonstrated MIT to enhance physical function with and without adjacent physical practice. A qualitative research study was conducted to examine the effectiveness of utilizing MIT as a depression and anxiety reducing alternative to exercise. Seven participants meeting the selection criteria were randomized into (a) the exercise group, or (b) the MIT group. The three participants in the exercise group engaged in two structured 20-minute aerobic exercise classes per week for three weeks. The four participants assigned to the MIT group engaged in the same dosage of structured MIT sessions. Data was collected through phenomenological interviews both before and after the exercise and MIT interventions. Four themes emerged from the interview, which included: (1) feeling refreshed and energized, (2) decrease in depressive-like symptoms, (3) overall improvement in mood perception, and (4) improvement in physical health. The results of the study suggest that the usage of MIT can improve aspects of mental health. Thus, it is proposed that future research should further investigate using MIT as a mental health improving alternative to exercise for those with physical activity restrictions.

Motor Imagery Combined With Physical Training Improves Response Inhibition in the Stop Signal Task.

BackgroundMotor imagery training has a similar effect to that of physical training on motor performance. The objective of this study was to investigate the short-term effectiveness of motor imagery training on response inhibition using the stop signal task (SST).MethodsParticipants were divided into a physical training group (PT, n = 17), a motor imagery training group (MIT, n = 17), and a motor imagery combined with physical training group (MIPT, n = 17). All participants performed 10 SST training sessions over 5 days. Both stop signal reaction time (SSRT) and non-signal reaction time (NSRT) were measured before and after SST training.ResultsThere were significant interaction (time × group) and time effects, although the group effect was not statistically significant. Bonferroni post hoc analysis showed that MIPT group revealed a significantly greater change in SSRT than PT and MIT groups, while there was no significant difference between PT and MIT groups. SSRT significantly decreased after training in all groups. In NSRT, there was a significant effect of time, but there was no significant interaction effect (time × group) or group effect.ConclusionResponse inhibition could be enhanced via training, and it was most effective when motor imagery and physical training were combined. We demonstrate that motor imagery training significantly improves response inhibition and should be accompanied by physical training when performing SST.

Effectiveness of Motor Imagery Training to Improve Gait Abilities of Patients with Sub-Acute Stroke

Aim: To determine the effectiveness of motor imagery training to improve the lower extremity function and gait in subjects with sub-acute stroke. Methods: Forty four patients with subacute stroke with gait impairment were randomly assigned to one of two groups: motor imagery training group or muscle relaxation group. At the beginning and after six weeks of therapy, the ability to use motor imagery and lower limb performance were assessed. Results: There were substantial differences of scores between both groups, with the motor imagery group progressing more than the muscle relaxation group. Conclusion: Motor imagery may have a beneficial and effective task-specific effect on gait function in sub-acute stroke patients. Keywords: motor imagery; gait rehabilitation; sub-acute stroke patients

Effectiveness of Motor Imagery Training to Improve Gait Abilities of Patients with Sub-Acute Stroke

Aim: To determine the effectiveness of motor imagery training to improve the lower extremity function and gait in subjects with sub-acute stroke. Methods: Forty four patients with subacute stroke with gait impairment were randomly assigned to one of two groups: motor imagery training group or muscle relaxation group. At the beginning and after six weeks of therapy, the ability to use motor imagery and lower limb performance were assessed. Results: There were substantial differences of scores between both groups, with the motor imagery group progressing more than the muscle relaxation group. Conclusion: Motor imagery may have a beneficial and effective task-specific effect on gait function in sub-acute stroke patients. Keywords: motor imagery; gait rehabilitation; sub-acute stroke patients

Effects of Motor Imagery Training on Balance and Gait in Older Adults: A Randomized Controlled Pilot Study.

The aim of this study was to demonstrate the effects of motor imagery training on balance and gait abilities in older adults and to investigate the possible application of the training as an effective intervention against fall prevention. Subjects (n = 34) aged 65 years and over who had experienced falls were randomly allocated to three groups: (1) motor imagery training group (MITG, n = 11), (2) task-oriented training group (TOTG, n = 11), and (3) control group (CG, n = 12). Each group performed an exercise three times a week for 6 weeks. The dependent variables included Path Length of center of pressure (COP)-based static balance, Berg Balance Scale (BBS) score, Timed Up and Go Test (TUG) score, which assesses a person’s mobility based on changes in both static and dynamic balance, Falls Efficacy Scale (FES) score, which evaluates changes in fear of falls, and gait parameters (velocity, cadence, step length, stride length, and H-H base support) to evaluate gait. After the intervention, Path Length, BBS, TUG, velocity, cadence, step length, and stride length showed significant increases in MITG and TOTG compared to CG (p < 0.05). Post hoc test results showed a significantly greater increase in BBS, TUG, and FES in MITG compared with TOTG and CG (p < 0.05). Our results suggest that motor imagery training combined with functional training has positive effects on balance, gait, and fall efficacy for fall prevention in the elderly.

Motor imagery and action observation for predictive control in developmental coordination disorder.

In 2019, international clinical practice recommendations on the definition, diagnosis, assessment, intervention, and psychosocial aspects of developmental coordination disorder (DCD) were published. Informing our understanding of mechanisms, recent systematic reviews have shown that children with DCD have difficulties with the predictive control of movements, including aspects of motor planning, which is expressed as the internal modeling deficit hypothesis. This motor control deficit is most evident when the spatial and temporal demands of a task increase. An increasing number of empirical studies suggest that motor planning problems can be remediated through training based on one or a combination of motor imagery and action observation. In this review, we show evidence of motor planning problems in children with DCD and show that task demands or complexity affects its appearance. Implications of these findings are treatments based on motor imagery and action observation to remediate motor planning issues. The article concludes with recommendations for future research.

Effects of Motor Imagery Training and Balance Training on Static Balance: A Quasi-Experimental Study

Background: Although studies on physical motor learning through motor imagery training have been conducted in various fields, studies on its effectiveness are still considered insufficient. Objective: To investigate the effect of motor imagery training and balance training on static balance of asymptomatic adults in their 20s. Design: A quasi-experimental study. Methods: Thirty-six adults in their 20s who passed the tandem stance test were randomized to the motor imagery training group (MIG, n=12), motor imagery with balance training group (MIBG, n=12), and balance training group (BG, n=12). Each group underwent their respective interventions three times a week for four weeks, and changes in static balance were analyzed using multivariate analysis of variance. Results: Trace length was significantly lower in the MIBG than in the MIG and BG (P<.05), and a significant reduction in trace length in the MIBG was observed after the intervention as compared to the baseline (P<.05). Furthermore, a significantly lower velocity was observed in the MIBG than in the MIG and BG (P<.05), and a significant reduction of velocity in the MIBG was more observed after the intervention compared to the baseline (P<.05). Conclusion: These results suggest that motor imagery training enhance static balance in healthy college students.

Motor Imagery Training After Stroke Increases Slow-5 Oscillations and Functional Connectivity in the Ipsilesional Inferior Parietal Lobule

Background. Reorganization in motor areas have been suggested after motor imagery training (MIT). However, motor imagery involves a large-scale brain network, in which many regions, andnot only the motor areas, potentially constitute the neural substrate for MIT. Objective. This study aimed to identify the targets for MIT in stroke rehabilitation from a voxel-based whole brain analysis of resting-state functional magnetic resonance imaging (fMRI). Methods. Thirty-four chronic stroke patients were recruited and randomly assigned to either an MIT group or a control group. The MIT group received a 4-week treatment of MIT plus conventional rehabilitation therapy (CRT), whereas the control group only received CRT. Before and after intervention, the Fugl-Meyer Assessment Upper Limb subscale (FM-UL) and resting-state fMRI were collected. The fractional amplitude of low-frequency fluctuations (fALFF) in the slow-5 band (0.01-0.027 Hz) was calculated across the whole brain to identify brain areas with distinct changes between 2 groups. These brain areas were then targeted as seeds to perform seed-based functional connectivity (FC) analysis. Results. In comparison with the control group, the MIT group exhibited more improvements in FM-UL and increased slow-5 fALFF in the ipsilesional inferior parietal lobule (IPL). The change of the slow-5 oscillations in the ipsilesional IPL was positively correlated with the improvement of FM-UL. The MIT group also showed distinct alternations in FCs of the ipsilesional IPL, which were correlated with the improvement of FM-UL. Conclusions. The rehabilitation efficiency of MIT was associated with increased slow-5 oscillations and altered FC in the ipsilesional IPL. Clinical Trial Registration. http://www.chictr.org.cn. Unique Identifier. ChiCTR-TRC-08003005.

The Reorganization of Resting-State Brain Networks Associated With Motor Imagery Training in Chronic Stroke Patients.

A number of studies have suggested that motor imagery training (MIT) has a positive influence on the upper extremity motor recovery in stroke patients, but little is known about its neural basis. To investigate the cortical motor network plasticity after MIT, 34 chronic hemiplegic subjects with subcortical stroke were recruited and randomly allocated to either the conventional rehabilitation therapy (CRT) or the CRT + MIT. The patients were assessed with the upper limb section of Fugl-Meyer assessment Scale (FM-UL) and resting-state fMRI before and after the 4 weeks of treatment. Seed-based functional connectivity (FC) of the ipsilesional primary motor cortex (M1) and graph-theory based analysis were used to explore the relationships between the motor recovery and reorganization of motor networks. We found that the patients in the MIT group showed more improvement in the FM-UL scores compared with the CRT group. Both groups presented increased inter-hemispheric and decreased intra-hemispheric FC of the ipsilesional M1 after intervention. However, the MIT group showed increased FC of the ipsilesional M1 with the ipsilesional precentral and postcentral gyri, middle cingulate gyrus and supramarginal gyrus after intervention, while the CRT group showed decreased FC in these regions. In addition, the clustering coefficient was significantly increased in the MIT group but not in the CRT group, and the increment of clustering coefficient was significantly positively correlated with improvement of FM-UL scores. Therefore, MIT might contribute to the motor recovery in stroke patients through the following network reorganization, i.e., promoting the efficiency of regional neuronal communication and the reorganization of intrinsic FC of the ipsilesional M1 involving widely distributed motor network in both hemispheres.

Using Motor Imagery Training to Increase Quadriceps Strength: A Pilot Study

Background: Motor imagery training implements neural adaptation theory to improve muscle strength without physically performing muscle contractions. To date, motor imagery training research regarding the efficacy of improving torque of the quadriceps over a brief training period is limited. Objective: To determine the impact of a 3-week motor imagery training on peak torque during knee extension. Method: Ten young, healthy volunteers were randomly assigned to 1 of 3 groups over a 3-week period: strength training, motor imagery training and control. Results: Following training, an increase in peak torque was observed in all strength training participants (mean change of 38 ± 15%) and in 2 members of the motor imagery training group (45 ± 10%). Conclusion: Brief periods of motor imagery training may have the potential to improve quadriceps strength; however, more research is needed with larger populations to test this hypothesis.

The plasticity of resting-state brain networks associated with motor imagery training in chronic stroke patients

Motor imagery training (MIT) is a widely used non-invasive treatment technique in stroke patients. Despite its clinical efficacy, little is known regarding the neural substrates underlying MIT. The aim of this study was to investigate the plasticity of resting-state brain networks associated with MIT in chronic stroke patients. A total of 34 chronic stroke patients with subcortical lesions were randomly assigned to the conventional rehabilitation therapy (CRT) group and the MIT group. Before and after the 4-week treatment, motor function of each patient was blindly assessed with Fugl–Meyer assessment Scale (FM-UL) and resting-state fMRI was administered. Functional connectivity (FC) analyses of the ipsilesional primary motor cortex (M1), measurements of the lateralization index (LI) and graph-theory based analysis were also performed in both group to investigate the altered whole-brain networks after treatment. Both groups showed significant improvement in FM-UL scores and the change in MIT group was significantly greater than that of the CRT group. Similar changes patterns of FC were seen between the MIT and CRT group: increased FC of the ipsilesional M1 with the contralesional precentral gyrus and decreased FC within ipsilesional hemisphere were found in both group. Additional increased FC of contralesional SMA and postcentral gyrus and restored LI were observed in MIT group. Moreover, a significant positive correlation between increase of clustering coefficient and improvement of FM-UL score were identified in MIT group as well ( P < 0.05). Our results indicate that the impact of MIT on the plasticity of brain networks was measurable on resting-state fMRI, and widely recruitment of the brain areas, restoring symmetry of the FC reflected by LI and increased clustering coefficients after treatment on a broader level of brain network analysis might be related to the neural mechanisms of motor recovery in stroke patients after MIT.

Can a single session of motor imagery promote motor learning of locomotion in older adults? A randomized controlled trial.

PurposeTo investigate the influence of a single session of locomotor-based motor imagery training on motor learning and physical performance.Patients and methodsThirty independent adults aged >65 years took part in the randomized controlled trial. The study was conducted within an exercise science laboratory. Participants were randomly divided into three groups following baseline locomotor testing: motor imagery training, physical training, and control groups. The motor imagery training group completed 20 imagined repetitions of a locomotor task, the physical training group completed 20 physical repetitions of a locomotor task, and the control group spent 25 minutes playing mentally stimulating games on an iPad. Imagined and physical performance times were measured for each training repetition. Gait speed (preferred and fast), timed-up-and-go, gait variability and the time to complete an obstacle course were completed before and after the single training session.ResultsMotor learning occurred in both the motor imagery training and physical training groups. Motor imagery training led to refinements in motor planning resulting in imagined movements better matching the physically performed movement at the end of training. Motor imagery and physical training also promoted improvements in some locomotion outcomes as demonstrated by medium to large effect size improvements after training for fast gait speed and timed-up-and-go. There were no training effects on gait variability.ConclusionA single session of motor imagery training promoted motor learning of locomotion in independent older adults. Motor imagery training of a specific locomotor task also had a positive transfer effect on related physical locomotor performance outcomes.

Neural mechanisms of strength increase after one-week motor imagery training

The neural mechanisms explaining strength increase following mental training by motor imagery (MI) are not clearly understood. While gains are mostly attributed to cortical reorganization, the sub-cortical adaptations have never been investigated. The present study investigated the effects of MI training on muscle force capacity and the related spinal and supraspinal mechanisms. Eighteen young healthy participants (mean age: 22.5 ± 2.6) took part in the experiment. They were distributed into two groups: a control group (n = 9) and an MI training group (n = 9). The MI group performed seven consecutive sessions (one per day) of imagined maximal isometric plantar flexion (4 blocks of 25 trials per session). The control group did not engage in any physical or mental training. Both groups were tested for the isometric maximal plantar flexion torque (MVC) and the rate of torque development (RTD) before and after the training session. In addition, soleus and medial gastrocnemius spinal and supraspinal adaptations were assessed through the recording of H-reflexes and V-waves, with electrical stimulations of the posterior tibial nerve evoked at rest and during MVC, respectively. After one week, only the MI training group increased both plantar flexion MVC and RTD. The enhancement of muscle torque capacity was accompanied by significant increase of electromyographic activity and V-wave during MVC and of H-reflex at rest. The increased cortical descending neural drive and the excitability of spinal networks at rest could explain the greater RTD and MVC after one week of MI training.

Effect of motor imagery therapy on cognitive function of patients with stroke

Objective To explore the rehabilitation effect of motor imagery therapy on cognitive function of stroke patients. Methods A total of 99 stroke patients with mild to moderate cognitive dysfunction were randomly divided into 3 groups: control group (N = 33), cognitive training group (N = 33) and motor imagery training group (N = 33). All patients received conventional rehabilitation training. Before and after 8-week training, all subjects were assessed with Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). At the same time, event-related potential (ERP) was examined to detect P300 latency and amplitude. Results ompared with before training, MMSE ( P = 0.000) and MoCA ( P = 0.000) scores were significantly increased, P300 latency was shortened ( P = 0.000) and P300 amplitude was increased ( P = 0.000) in 3 groups after 8 - week training. There were significant differences among 3 groups on MMSE ( P = 0.030) and MoCA ( P = 0.013) scores, P300 latency ( P = 0.004) and P300 amplitude ( P = 0.009) before and after training. Among them, cognitive training group and motor imagery training group had significantly higher MMSE ( P = 0.019, 0.021) and MoCA ( P = 0.003, 0.031) scores, shorter P300 latency ( P = 0.020, 0.003) and higher P300 amplitude ( P = 0.003, 0.002) than control group. Conclusions Motor imagery training can not only improve motor function of stroke patients, but also improve their cognitive function. DOI: 10.3969/j.issn.1672-6731.2017.06.005

The effect of motor imagery training for trunk movements on trunk muscle control and proprioception in stroke patients.

[Purpose] The present study was conducted to evaluate the effect of motor imagery training for trunk movements on trunk muscle control and proprioception in stroke patients. [Subjects and Methods] A total of 12 study subjects were randomly assigned to the experimental group (a motor imagery training group) and the control group (a neurodevelopmental treatment, NDT) group. The two groups were treated five times (30 minutes each time) per week for 4 weeks. The experimental group underwent imagery training for 10 minutes and trunk control centered NDT for 20 minutes and the control group underwent only trunk control centered NDT for 30 minutes. The trunk muscle activity and the position sense of the subjects were evaluated before and after the intervention. [Results] The two groups showed significant improvements in muscle activity after the intervention. Only the experimental group showed significant improvements in proprioception. The experimental group showed significant improvements in the variations of muscle activity and proprioception compared to the control group. [Conclusion] Motor imagery training for trunk movements can be effectively used to improve trunk muscle activity and proprioception in stroke patients.

경부 관절가동술을 병행한 복합운동이 편타성 손상에 의한 급성 경부통환자의 기능적 변인 및 통증척도에 미치는 영향

The purpose of this study was to investigate the effectiveness of combined exercise program applying mobilization on functional variables and pain scale of patients with acute neck pain caused by whiplash injury BR The subjects of this study were 28 patients with acute neck pain caused by whiplash injury. Participants were randomly assigned to motor imagery training group(n=15) and a physical therapy group(n=13). Two groups was executed during 60min a daily, 4 times a week during 3 weeks. All date were analyzed by paired t-test and independent t-test of SPSS/PC ver. 12.0.BR After 3 weeks of combined exercise program applying cervical joint mobilization were found to be significantly effective in functional variable(muscle activation of neck, maximal muscle strength & muscle endurance of neck flexor neck disability index) and pain scale. These reuslts suggest that JCMG were more significantly increased on functional variable and pain scale than PTG. In conclusion, the combined exercise program applying cervical joint mobilization in patients with acute neck pain caused by whiplash injury was effective for improvement in muscle functional and pain control.BR

Influence of motor imagery training on gait rehabilitation in sub-acute stroke: A randomized controlled trial.

To evaluate the effect of mental practice on motor imagery ability and assess the influence of motor imagery on gait rehabilitation in sub-acute stroke. Randomized controlled trial. A total of 44 patients with gait dysfunction after first-ever stroke were randomly allocated to a motor imagery training group and a muscle relaxation group. The motor imagery group received 6 weeks of daily mental practice. The relaxation group received a muscle relaxation programme of equal duration. Motor imagery ability and lower limb function were assessed at baseline and after 6 weeks of treatment. Motor imagery ability was tested using a questionnaire and mental chronometry test. Gait outcome was evaluated using a 10-m walk test (near transfer) and the Fugl-Meyer assessment (far transfer). Significant between-group differences were found, with the vividness of kinesthetic imagery and the walking test results improving more in the motor imagery group than in the muscle relaxation group. There was no group interaction effect for the far transfer outcome score. Motor imagery training may have a beneficial task-specific effect on gait function in sub-acute stroke; however, longer term confirmation is required.

Action observation training for functional activities after stroke: A pilot randomized controlled trial

The objective of this study was to compare the effects of action observation training and motor imagery training on recovery from chronic stroke. Thirty patients who were more than six months post stroke participated in this study and were randomly allocated to three groups. The action observation training group practiced additional action observation training for five 30-minute sessions over a four-week period. The motor imagery training group practiced additional motor imagery training for five 30-minute sessions over a four-week period. The following clinical measures were used for assessment of dynamic balance and gait abilities: Timed Up and Go Test, Functional Reaching Test, Walking Ability Questionnaire, and Functional Ambulation Category. Spatiotemporal gait parameters were also collected using a GAITRite system. Compared with the physical training group, the action observation training group showed significant improvement in the Timed Up and Go test, gait speed, cadence, and single limb support of the affected side. No significant differences in any of the outcome measures were observed between the action observation training group and the motor imagery training group. Action observation training and motor imagery training results in improvement of dynamic balance and gait ability. These results suggest the feasibility and suitability of action observation training for patients with chronic stroke.

Cortical reorganization after motor imagery training in chronic stroke patients with severe motor impairment: a longitudinal fMRI study

Despite its clinical efficacy, few studies have examined the neural mechanisms of motor imagery training (MIT) in stroke. Our objective was to find the cortical reorganization patterns after MIT in chronic stroke patients. Twenty stroke patients with severe motor deficits were randomly assigned to the MIT or conventional rehabilitation therapy (CRT) group, but two lost in the follow-up. All 18 patients received CRT 5 days/week for 4 weeks. Nine subjects in the MIT group received 30-min MIT 5 days/week for 4 weeks. Before and after the interventions, the upper limb section of the Fugl-Meyer Scale (FM-UL) was blindly evaluated, and functional magnetic resonance imaging was administered while the patients executed a passive fist clutch task. Two cortical reorganization patterns were found. One pattern consisted of the growth in activation in the contralateral sensorimotor cortex (cSMC) for most patients (six in the MIT group, five in the CRT group), and the other consisted of focusing of the activation in the cSMC with increasing of the laterality index of the SMC for a small portion of patients (three in the MIT group, one in the CRT group). When we applied correlation analyses to the variables of relative ΔcSMC and ΔFM-UL in the 11 patients who experienced the first pattern, a positive relationship was detected. Our results indicate that different cortical reorganization patterns (increases in or focusing of recruitment to the cSMC region) exist in chronic stroke patients after interventions, and patients may choose efficient patterns to improve their motor function.