Department of Physical Therapy, Rio Grande do Norte Federal University, Natal, Rio Grande do Norte, Brazil.
Anita Garibaldi Education and Health Research Center, Santos Dumont Institute, Macaíba, Rio Grande do Norte, Brazil.
Eur J Phys Rehabil Med. 2022 Oct;58(5):715-722. doi: 10.23736/S1973-9087.22.07313-0. Epub 2022 Sep 1.
Combining action observation (AO) and motor imagery (MI) training may induce greater brain activity in areas usually involved in Parkinson's disease (PD) and lead to greater behavioral and neurophysiological effects than when used separately.
To determine the effects of combining AO, MI, and gait training on balance and freezing of gait in individuals with PD.
This is a single-blinded, randomized controlled clinical trial.
Laboratory of Intervention and Analysis of Movement (LIAM) from the Department of Physical Therapy of a Brazilian University.
Study sample consisted of individuals diagnosed with idiopathic PD by a neurologist specialized in movement disorders.
39 individuals with PD were divided into experimental (EG=21) and control groups (CG=18). EG performed 12 sessions of AO, MI, and gait training, whereas CG watched PD-related educational videos and performed 12 sessions of gait training. Balance (measured using the Mini Balance Evaluation Systems Test [MiniBESTest]) and freezing of gait (measured using the Freezing of Gait Questionnaire) were reassessed one day after the end of the intervention.
We did not observe significant intra- and intergroup differences in freezing of gait. For the EG, we observed a significant intragroup difference in the total score of MiniBESTest (F=5.2; P=0.02), and sensory orientation (F=4.5; P=0.04) and dynamic gait (F=3.6; P=0.03) domains. MiniBESTest domains were not different between groups.
Combining AO, MI, and gait training was not more effective than isolated gait training for balance and freezing of gait in individuals with PD.
MI training can moderate AO effects and enhance motor learning when both therapies are combined. Therefore, this approach may still have the potential to be included in the treatment of PD. New studies should investigate whether the factors that influence these results are related to the protocol's sensitivity in changing the evaluated parameters or to the time and intensity of AO and MI training.
结合动作观察（AO）和运动想象（MI）训练可能会引起帕金森病（PD）相关区域更大的脑活动，并导致比单独使用时更大的行为和神经生理效应。
确定 AO、MI 和步态训练相结合对 PD 患者平衡和步态冻结的影响。
这是一项单盲、随机对照临床试验。
巴西某大学理疗系运动干预与分析实验室（LIAM）。
研究样本由运动障碍专家诊断为特发性 PD 的个体组成。
39 名 PD 患者分为实验组（EG=21）和对照组（CG=18）。EG 进行了 12 次 AO、MI 和步态训练，而 CG 观看了与 PD 相关的教育视频并进行了 12 次步态训练。平衡（使用 Mini 平衡评估系统测试 [MiniBESTest] 测量）和步态冻结（使用步态冻结问卷测量）在干预结束后一天重新评估。
我们没有观察到步态冻结的组内和组间差异有统计学意义。对于 EG，我们观察到 MiniBESTest 总分（F=5.2；P=0.02）和感觉定向（F=4.5；P=0.04）和动态步态（F=3.6；P=0.03）领域的组内差异有统计学意义。MiniBESTest 各领域在组间无差异。
与单独的步态训练相比，结合 AO、MI 和步态训练对 PD 患者的平衡和步态冻结没有更有效。
当两种疗法结合使用时，MI 训练可以调节 AO 的效果并增强运动学习。因此，这种方法仍有可能被纳入 PD 的治疗中。新的研究应调查影响这些结果的因素是与评估参数变化的方案敏感性有关，还是与 AO 和 MI 训练的时间和强度有关。
