Influence of functional task-oriented mental practice on the gait of transtibial amputees: a randomized, clinical trial

Abstract

BackgroundMental practice (MP) through motor imagery is a cognitive training strategy used to improve locomotor skills during rehabilitation programs. Recent works have used MP tasks to investigate the neurophysiology of human gait; however, its effect on functional performance has not been evaluated. In the present study, the influence of gait-oriented MP tasks on the rehabilitation process of gait in transtibial amputees was investigated by assessing the vertical (V), anterior-posterior (AP), and medio-lateral (ML) ground reaction forces (GRFs) and the time duration of the support phase of the prosthetic limb.MethodsUnilateral transtibial amputees, who were capable of performing motor imagination tasks (MIQ-RS score ≥4), were randomly divided into two groups: Group A (n = 10), who performed functional gait-oriented MP combined with gait training, and Group B (n = 5), who performed non-motor task MP. The MP intervention was performed in the first-person perspective for 40 min, 3 times/week, for 4 weeks. The GRF outcome measures were recorded by a force platform to evaluate gait performance during 4 distinct stages: at baseline (BL), 1 month before the MP session; Pre-MP, 1–3 days before the MP session; Post-MP, 1–3 days after the MP session; and follow-up (FU), 1 month after MP session. The gait variables were compared inter- and intra-group by applying the Mann-Whitney and Friedman tests (alpha = 0.05).ResultsAll volunteers exhibited a homogenous gait pattern prior to MP intervention, with no gait improvement during the BL and Pre-MP stages. Only Group A showed significant improvements in gait performance after the intervention, with enhanced impact absorption, as indicated by decreased first V and AP peaks; propulsion capacity, indicated by increasing second V and AP peaks; and balance control of the prosthetic limb, indicated by decreasing ML peaks and increasing duration of support. This gait pattern persisted until the FU stage.ConclusionsMP combined with gait training allowed transtibial amputees to reestablish independent locomotion. Since the effects of MP were preserved after 1 month, the improvement is considered related to the specificity of the MP tasks. Therefore, MP may improve the clinical aspect of gait rehabilitation when included in a training program.

The Effects of 24-Hour Sleep Deprivation on Cognitive and Motor Skills of Male College Students

“…Indeed, an observer does not physically practice the task and consequently he or she does not risk injury or expend the same amount of energy as a practitioner during learning (19).Mental practice is a dynamic state in which the subject evokes an imaginary representation of a motor action or skill in order to learn or perfect that action (20). MP is a cognitive strategy procedure based on extensively repeated motor imagery tasks, which can enhance the acquisition of motor ability and functional performance, without physical execution of movements (21). Both motor imagery and action observation have been shown to play a role in learning or re-learning motor tasks (22).…”

Adapting Motor Imagery Training Protocols to Surgical Education: A Systematic Review and Meta-Analysis

“…23 studies (38%) used the MIQ, MIQ-RS, VMIQ, VMIQ-2, VVIQ, mental chronometry, KVIQ or time-dependent motor imagery (TDMI) to select participants based on MI ability. 6 , 12 , 24 , 34 , 38 , 40 - 43 , 45 , 47 , 48 , 53 , 55 , 57 , 60 - 62 , 64 , 66 , 68 , 72 , 79 Out of these, 12 (52%) reported better outcomes in the intervention group compared to control. 12 , 53 , 55 , 57 , 60 - 62 , 64 , 66 , 68 , 72 , 79 …”

“…In 35 studies (58%), the intervention group performed better than the control group. 3 , 12 , 25 , 32 , 33 , 50 - 79 In 29/35 studies (83%), the intervention group which did MP and standard physical practice (rehabilitation, physiotherapy and surgical training) performed better than the control group which did only standard physical practice. 3 , 12 , 25 , 32 , 33 , 50 - 70 , 76 , 78 , 79 There was no trend found between these study results and the use of MI ability assessment, the outcome measures used or the length of interventions.…”

The effects of body position and actual execution on motor imagery of locomotor tasks in people with a lower-limb amputation

“…Only a few studies have tried to disentangle whether changes in MI ability occur after a lower-limb amputation (LLA) despite the critical structural and functional alterations occurring in the sensorimotor system after LLA and the potential for MI training in this population 13 , 14 . The findings so far indicate that MI vividness (i.e.…”