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增强运动想象处理以改善帕金森病和步态冻结患者的步态:一项初步研究。

Boostering motor imagery processing to improve gait in patients with Parkinson disease and freezing of gait: A pilot study.

作者信息

Mezzarobba Susanna, Ravizzotti Elisa, Bernardis Paolo, Putzolu Martina, Cosentino Carola, Botta Alessandro, Bonassi Gaia, Marchese Roberta, Terranova Sara, Lagravinese Giovanna, Avanzino Laura, Pelosin Elisa

机构信息

Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy; IRCCS, Ospedale Policlinico San Martino, Genoa, Italy.

Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy.

出版信息

Parkinsonism Relat Disord. 2024 Dec;129:107173. doi: 10.1016/j.parkreldis.2024.107173. Epub 2024 Oct 15.

Abstract

BACKGROUND

Given that patients with Parkinson's Disease (PD) and Freezing of Gait (FoG) may lack the cognitive resources necessary to activate the motor imagery (MI) process, investigating how to boost MI vividness and accuracy could be a valuable therapeutic strategy in MI Practice (MIP).

OBJECTIVE

We aim to evaluate the priming effect of visual, or auditory, or attentional stimuli in enhancing MI ability by using quantitative data on gait and turning performance.

METHODS

Nineteen PD participants with FoG underwent four one-week sessions of MIP, with pre and post clinical assessments. Each session included MI alone or one of three booster MI tasks (Attentional, Action observation, or Auditory) before imagining and executing walking straight and performing a 180° turn. Gait and turning performances were evaluated using six inertial sensors before and after each session.

RESULTS

Our findings showed that both MI and boosted MI induced similar improvement in gait (speed and stride length) and 180° (step number and velocity) and 360° turning (velocity, angle) parameters compared to baseline. When differences among "booster" tasks were analyzed, results showed that Auditory and Attentional boosted MI were superior to MI alone in some gait and turning parameters. At the end of the 4 sessions, MI ability measured by means of Kinesthetic and Visual Imagery Questionnaire and Gait Imagery Questionnaire and FoG symptoms were also improved.

CONCLUSION

Our preliminary results suggest that boosting MI is a feasible strategy for enhancing MI ability and addressing FoG symptoms. Auditory and Attentional conditions appear to enhance the priming effect of MI on gait and turning performance more effectively.

摘要

背景

鉴于帕金森病(PD)和冻结步态(FoG)患者可能缺乏激活运动想象(MI)过程所需的认知资源,研究如何提高MI的生动性和准确性可能是MI训练(MIP)中有价值的治疗策略。

目的

我们旨在通过使用步态和转弯表现的定量数据,评估视觉、听觉或注意力刺激在增强MI能力方面的启动效应。

方法

19名患有FoG的PD参与者接受了为期四周的MIP训练,训练前后进行临床评估。每个训练阶段包括单独的MI训练,或在想象并执行直线行走和180°转弯之前进行的三种增强MI任务(注意力、动作观察或听觉)之一。在每个训练阶段前后,使用六个惯性传感器评估步态和转弯表现。

结果

我们的研究结果表明,与基线相比,MI训练和增强MI训练在步态(速度和步长)、180°(步数和速度)和360°转弯(速度、角度)参数方面均产生了类似的改善。在分析“增强”任务之间的差异时,结果表明,在一些步态和转弯参数方面,听觉和注意力增强的MI训练优于单独的MI训练。在四个训练阶段结束时,通过动觉和视觉想象问卷、步态想象问卷测量的MI能力以及FoG症状也得到了改善。

结论

我们的初步结果表明,增强MI是提高MI能力和缓解FoG症状的可行策略。听觉和注意力条件似乎能更有效地增强MI对步态和转弯表现的启动效应。

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