Integration of motor imagery and physical practice in group treatment applied to subjects with Parkinson's disease.

BACKGROUND AND PURPOSE: The application of motor imagery practice in the treatment of Parkinson's disease (PD) is a novel treatment approach for improving motor function. The purpose of this study was to compare group treatment using a combination of physical and motor imagery practice with group treatment using only physical practice in subjects with PD.

METHODS: Of 23 patients with idiopathic PD, 12 received combined therapy, whereas 11 received physical therapy alone. Exercises for both groups were applied during 1-h sessions held twice a week for 12 weeks. Comparable motor tasks provided to both groups included callisthenic exercises, functional tasks, and relaxation exercises. However, the experimental group was treated with both imagery and real practice, whereas the control group received only physical exercises. Outcome measures included the time required to complete sequences of movements, the performance of balance tasks, impairment and functional scores on the Unified Parkinson's Disease Rating Scale (UPDRS), and specific cognitive abilities (Stroop and clock drawing tests).

RESULTS: Following the intervention, the combined treatment group exhibited significantly faster performance of movement sequences than the control group. In addition, the experimental subjects demonstrated higher gains in the mental and motor subsets of the UPDRS and in the cognitive tests. Both groups improved on the activities of daily living scale.

CONCLUSIONS: The combination of motor imagery and real practice may be effective in the treatment of PD, especially for reducing bradykinesia. The implementation of this treatment regimen allows for the extension of practice time with negligible risk and low cost.