EFFECTS OF COMBINING MOTOR IMAGERY WITH MOTOR TRAINING ON BALANCE AND GAIT IN PEOPLE WITH PARKINSON’S DISEASE

Balance and gait disturbances are among the most disabling symptoms in people with Parkinson’s disease (PD). Although integrating motor imagery (MI) with physical practice improved time needed to complete a sequence of movements in PD, its effects on balance and gait remain unclear. This single-blind randomized controlled trial investigated combining MI and motor training on balance and gait performance in people with PD. Inclusion criteria were: (1) aged 40-85 years, (2) diagnosis of idiopathic PD by neurologist with Hoehn and Yahr stage < 4, (3) stable medical condition, (4) capability of walking independently for 10 minutes, and (5) Mini-Mental state examination score ≥ 24. Participants were randomly assigned to MI and motor training (MI) group (n = 6) or motor training-only (MT) group (n = 6). MI group received 20 minutes of guided MI followed by 20 minutes of motor training, whereas MT group received 40 minutes of motor training each session, 2-3 sessions/week for a total of 12 sessions. Outcomes were assessed at baseline, post-intervention, and 1-month follow-up, including the Mini-Balance Evaluation Systems Test (Mini-BEST), Timed Up and Go test, and gait speed and variability. Both groups showed significant within-group improvements in Mini-BEST and step length variability of the more affected limb after training. At 1-month follow-up, these significant gains were maintained only in the MI group. In conclusion, substituting half of the physical training time with MI produced comparable short-term improvements and may better support the maintenance of balance and gait gains at follow-up in people with PD.