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Background: Motor imagery (MI) has become an increasingly popular rehabilitation tool for individuals with motor impairments. However, it has been proposed that individuals with Parkinson’s Disease (PKD) may not benefit from MI due to impairments in motor learning. Objective: This case series study investigated the effects of a 4-week MI training protocol on MI ability in three male individuals with PKD, with an emphasis on examining changes in brain responses. Methods: Training was completed primarily at home, via audio recordings, and emphasized the imagination of functional tasks. MI ability was assessed pre and post-training using subjective and objective imagery questionnaires, alongside an electroencephalographic (EEG) recording of a functional MI task. EEG analysis focused on the mu rhythm, as it has been proposed that suppression in the mu rhythm may reflect MI success and motor learning. Previous research has indicated that mu suppression is impaired in individuals with PKD, and may contribute to the disease’s associated deficits in motor learning. Results: Following training, all three participants improved in MI accuracy, but reported no notable improvements in MI vividness. Greater suppression in the mu rhythm was also exhibited by all three participants post-training. Conclusion: These results suggest the participants learned from the training protocol and that individuals with PKD are responsive to MI training. Further research on a larger scale is needed to verify the findings and determine if this learning translates to improvements in motor function.

Motor imagery, or our ability to imagine movement without actually engaging in the action, has been an increasingly popular tool in rehabilitation settings. Understanding its neural underpinning is crucial for further development of new interventions. Using scalp electroencephalography (EEG), many studies have shown that mu oscillations (8-13 Hz), a variant of the alpha band recorded over the motor cortex electrodes, are involved in both the imagination and performance of movements; however, the exact relationship between mu oscillations and motor imagery is unclear. To further our understanding of the functional significance of mu oscillations and their role in both motor learning and motor performance, our study sought to investigate how suppression in mu oscillations varies during a motor imagery task according to both within subject imagery success and between subject imagery ability. We examined EEG activity while a large sample of participants performed an objective test of motor imagery ability (Test of Ability in Movement Imagery, TAMI). Results demonstrated that mu oscillatory activity significantly decreased during successful imagery trials as compared to unsuccessful ones. However, the extent of reduction in mu oscillations did not correlate with individual imagery ability. These results provide further support for the involvement of mu oscillations in motor behaviors and indicate that suppression in mu oscillations may serve as an important index for determining successful motor imagery performance within an individual. The processes that underlie this success are likely similar to those that underlie successful motor execution, given motor imagery's proposed functional equivalence to motor imagery.

Introduction: Motor imagery (MI) may be an effective tool for improving activities of daily living (ADL) post-stroke. However, no review to date has examined ADL independence when investigating training effectiveness. This review aimed to evaluate the quality of evidence and the effectiveness of MI training for improving ADL independence post-stroke. Method: Randomized controlled trial (RCT) studies comparing MI to conventional therapies were reviewed. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale. Results: Thirteen articles met inclusion criteria. The overall quality was considered moderate to good, with a PEDro score ranging from 3 to 8. Most studies (9 out of 13) were considered good quality, with one rating of poor quality and three of fair quality. The primary findings suggest that MI training is a low-risk tool that may facilitate ADL independence. Audio-based MI training seems to improve ADL independence when paired with other rehabilitation methods, but the results should be interpreted with caution. Conclusion: To our knowledge, this is the first systematic review to examine RCTs investigating MI effectiveness in improving ADL post-stroke. Results support the use of MI to facilitate ADL independence. However, more research is needed to establish practice guidelines for implementing MI training post-stroke.