Practising movements in the mind

Parkinson's disease (PD) is the second most common neurodegenerative disease, characterized pathologically by the progressive loss of dopaminergic neurons in the substantia nigra and clinically by the presence of motor symptoms such as bradykinesia, resting tremor, and/or rigidity. Among the motor deficits frequently observed in PD, patients are known to frequently report difficulties with manual dexterity.Typical features of balance deficits in PD include decreased sway, decreased base of support, rigidity, abnormal intersegmental coordination, and postural misalignment. Related somatosensory deficits in PD include problems orienting to and processing sensory and somatosensory information.Motor imagery (MI) is the imaginal execution of motor activities or the activation of specific muscles in the absence of any explicit feedback. This area of rehabilitation has been shown to be effective in improving and developing motor skills in many neurological conditions where patients exhibit motor recognition and execution impairments. MI can be applied at all stages of recovery from PD, is highly effective in movement-related pathologies, and can be performed independently.Studies evaluating the effect of mental imagery training on balance measures in PD are limited. One study evaluating the effect of combined MI-physical therapy versus physical therapy alone group treatment noted positive trends toward balance improvements in the combined group. In a case study of a single participant with PD, a 3-month neurocognitive rehabilitation program incorporating mental imagery over 20 sessions resulted in balance improvements and a reduced risk of falls in both the "OFF" and "ON" phases, as measured by the Tinetti Balance and Gait Assessment Scale.The aim of this study is to investigate the effects of motor imagery training on kinesiophobia, walking and balance in patients with Parkinson's disease.