A different point of view: the evaluation of motor imagery perspectives in patients with sensorimotor impairments in a longitudinal study

Abstract

Background Motor imagery (MI) has been successfully applied in neurological rehabilitation. Little is known about the spontaneous selection of the MI perspectives in patients with sensorimotor impairments. What perspective is selected: internal (first-person view), or external (third-person view)? The aim was to evaluate the MI perspective preference in patients with sensorimotor impairments. Methods In a longitudinal study including four measurement sessions, 55 patients (25 stroke, 25 multiple sclerosis, 5 Parkinson’s disease; 25 females; mean age 58 ± 14 years) were included. MI ability and perspective preference in both visual and kinaesthetic imagery modalities were assessed using the Kinaesthetic and Visual Imagery Questionnaire-20 (KVIQ-20), the body rotation task (BRT), and mental chronometry (MC). Additionally, patients’ activity level was assessed. Descriptive analyses were performed regarding different age- (< 45, 45–64, > 64), activity levels (inactive, partially active, active), and KVIQ-20 movement classifications (axial, proximal, distal, upper and lower limb). A mixed-effects model was used to investiage the relationship between the primary outcome (MI perspective: internal, external) with the explanatory variables age, MI modality (visual, kinaesthetic), movement type (axial, proximal, distal), activity levels and the different assessments (KVIQ-20, BRT, MC). Results Imagery modality was not a significant predictor of perspective preference. Over the four measurement sessions, patients tended to become more consistent in their perspective selection, however, time point was not a significant predictor. Movement type was a significant predictor: imagination of distal vs. axial and proximal vs. axial movements were both associated with preference for external perspective. Patients with increased physical activity level tend to use internal imagery, however, this effect was borderline not statistically significant. Age was neither a significant precictor. Regarding the MI assessments, the KVIQ- 20 score was a significant predictor. The patients with higher test scores tend to use the external perspective. Conclusion It is recommended to evaluate the spontaneous MI perspective selection to design patient-specific MI training interventions. Distal movements (foot, finger) may be an indicator when evaluating the consistency of the MI perspective in patients with sensorimotor impairments.

Exploring Motor Imagery as a Therapeutic Intervention for Parkinson’s Disease Patients: A Scoping Review

“…Twenty-one out of 41 studies did not mention inclusion criteria. Four studies included patients with other neurological conditions such as stroke, multiple sclerosis, Huntington’s disease (39–42).…”

Action Observation and Motor Imagery as a Treatment in Patients with Parkinson’s Disease

“…Observing or imagine more complex motor tasks may take longer and deteriorate imitation abilities after AO or the quality of MI. In some cases, a 3rdP perspective both for AO and MI might be more beneficial for fostering motor learning [6,37]. -Familiarity of Movement: The familiarity of the movement being observed or imagined plays a role in the effectiveness of AOT and MIT.…”

Event-Related EEG Desynchronization Reveals Enhanced Motor Imagery From the Third Person Perspective by Manipulating Sense of Body Ownership With Virtual Reality for Stroke Patients

“…First, 3PP viewpoints could overcome the field of view limitations of the 1PP [28], [29]. Second, some axial movements like shoulder shrugging are more easily imagined from the 3PP [30]. However, training may be less effective when the visual cue is from the 3PP [31].…”