Verónica Robles-García1, Yoanna Corral-Bergantiños1, Nelson Espinosa1, Carlos García-Sancho2, Gabriel Sanmartín3, Julián Flores3, Javier Cudeiro4, Pablo Arias5. 1. Neuroscience and Motor Control Group (NEUROcom), Faculty of Health Sciences, INEF-Galicia, and Faculty of Physiotherapy; Universidade da Coruña (Spain) and Institute of Biomedical Research of A Coruña, Spain. 2. Movement Disorders Unit, University of A Coruña Hospital, A Coruña, Spain. 3. Instituto de Investigaciones Tecnológicas, University of Santiago de Compostela, Spain. 4. Neuroscience and Motor Control Group (NEUROcom), Faculty of Health Sciences, INEF-Galicia, and Faculty of Physiotherapy; Universidade da Coruña (Spain) and Institute of Biomedical Research of A Coruña, Spain; Centro de Estimulación Cerebral de Galicia, Spain. 5. Neuroscience and Motor Control Group (NEUROcom), Faculty of Health Sciences, INEF-Galicia, and Faculty of Physiotherapy; Universidade da Coruña (Spain) and Institute of Biomedical Research of A Coruña, Spain. Electronic address: pabloarias.neurocom@udc.es.
Abstract
BACKGROUND: Hypometria is a clinical motor sign in Parkinson's disease. Its origin likely emerges from basal ganglia dysfunction, leading to an impaired control of inhibitory intracortical motor circuits. Some neurorehabilitation approaches include movement imitation training; besides the effects of motor practice, there might be a benefit due to observation and imitation of un-altered movement patterns. In this sense, virtual reality facilitates the process by customizing motor-patterns to be observed and imitated. OBJECTIVE: To evaluate the effect of a motor-imitation therapy focused on hypometria in Parkinson's disease using virtual reality. METHODS: We carried out a randomized controlled pilot-study. Sixteen patients were randomly assigned in experimental and control groups. Groups underwent 4-weeks of training based on finger-tapping with the dominant hand, in which imitation was the differential factor (only the experimental group imitated). We evaluated self-paced movement features and cortico-spinal excitability (recruitment curves and silent periods in both hemispheres) before, immediately after, and two weeks after the training period. RESULTS:Movement amplitude increased significantly after the therapy in the experimental group for the trained and un-trained hands. Motor thresholds and silent periods evaluated with transcranial magnetic stimulation were differently modified by training in the two groups; although the changes in the input-output recruitment were similar. CONCLUSIONS: This pilot study suggests that movement imitation therapy enhances the effect of motor practice in patients with Parkinson's disease; imitation-training might be helpful for reducing hypometria in these patients. These results must be clarified in future larger trials.
RCT Entities:
BACKGROUND: Hypometria is a clinical motor sign in Parkinson's disease. Its origin likely emerges from basal ganglia dysfunction, leading to an impaired control of inhibitory intracortical motor circuits. Some neurorehabilitation approaches include movement imitation training; besides the effects of motor practice, there might be a benefit due to observation and imitation of un-altered movement patterns. In this sense, virtual reality facilitates the process by customizing motor-patterns to be observed and imitated. OBJECTIVE: To evaluate the effect of a motor-imitation therapy focused on hypometria in Parkinson's disease using virtual reality. METHODS: We carried out a randomized controlled pilot-study. Sixteen patients were randomly assigned in experimental and control groups. Groups underwent 4-weeks of training based on finger-tapping with the dominant hand, in which imitation was the differential factor (only the experimental group imitated). We evaluated self-paced movement features and cortico-spinal excitability (recruitment curves and silent periods in both hemispheres) before, immediately after, and two weeks after the training period. RESULTS: Movement amplitude increased significantly after the therapy in the experimental group for the trained and un-trained hands. Motor thresholds and silent periods evaluated with transcranial magnetic stimulation were differently modified by training in the two groups; although the changes in the input-output recruitment were similar. CONCLUSIONS: This pilot study suggests that movement imitation therapy enhances the effect of motor practice in patients with Parkinson's disease; imitation-training might be helpful for reducing hypometria in these patients. These results must be clarified in future larger trials.
Authors: Michelle Sophie Keller; Hannah J Park; Maria Elena Cunningham; Joshua Eleazar Fouladian; Michelle Chen; Brennan Mason Ross Spiegel Journal: J Med Internet Res Date: 2017-12-19 Impact factor: 5.428
Authors: Muhammad Kashif; Ashfaq Ahmad; Muhammad Ali Mohseni Bandpei; Maryam Farooq; Humaira Iram; Rida E Fatima Journal: Medicine (Baltimore) Date: 2022-08-05 Impact factor: 1.817