Effects of movement imitation training in Parkinson's disease: A virtual reality pilot study. (May 2016)

• Record Type: Journal Article
• Authors: Robles-García, Verónica; Corral-Bergantiños, Yoanna; Espinosa, Nelson; García-Sancho, Carlos; Sanmartín, Gabriel; Flores, Julián; Cudeiro, Javier; Arias, Pablo
• Is Part Of: Parkinsonism & related disorders. Volume 26(2016)
• Page Start: 17
• Page End: 23
• Publication Date: 2016-05
• Subjects: Hypokinesia -- Learning -- Imitative behaviour -- Parkinson's disease -- Virtual reality therapy -- Transcranial magnetic stimulation; (AMT) active motor threshold (BG) basal ganglia -- (CV) Coefficient of variation (EHI) Edinburgh Handedness Inventory -- (EG) experimental group (FDI) first dorsal interosseus -- (HMD) head mounted display (Hless/more-affected) less/more affected hemisphere -- (I/O curve) input–output curve (LH) left hemisphere -- (MVC) maximal voluntary contraction (M1) motor cortex -- (ML) motor learning (MP) motor practice -- (MEP) motor evoked potential (PD) Parkinson's disease -- (PDp) patients with Parkinson's disease (CG) active control group -- (RH) right hemisphere (RMT) rest motor threshold -- (SP) silent period (TMS) transcranial magnetic stimulation -- (UPDRS) Unified Parkinson Disease Rating Scale (VR) virtual reality; Parkinson's disease -- Periodicals; Movement disorders -- Periodicals; Movement Disorders -- Periodicals; Nerve Degeneration -- Periodicals; Nervous System Diseases -- Periodicals; Parkinson Disease -- Periodicals; Tremor -- Periodicals; Parkinson, Maladie de -- Périodiques; Parkinson's disease; 616.833
• DOI: 10.1016/j.parkreldis.2016.02.022
• Languages: English
• ISSNs: 1353-8020

Abstract

Abstract: Background: Hypometria is a clinical motor sign in Parkinson's disease. Its origin likely emerges from basal ganglia dysfunction, leading to an impaired control of inhibitory intracortical motor circuits. Some neurorehabilitation approaches include movement imitation training; besides the effects of motor practice, there might be a benefit due to observation and imitation of un-altered movement patterns. In this sense, virtual reality facilitates the process by customizing motor-patterns to be observed and imitated. Objective: To evaluate the effect of a motor-imitation therapy focused on hypometria in Parkinson's disease using virtual reality. Methods: We carried out a randomized controlled pilot-study. Sixteen patients were randomly assigned in experimental and control groups. Groups underwent 4-weeks of training based on finger-tapping with the dominant hand, in which imitation was the differential factor (only the experimental group imitated). We evaluated self-paced movement features and cortico-spinal excitability (recruitment curves and silent periods in both hemispheres) before, immediately after, and two weeks after the training period. Results: Movement amplitude increased significantly after the therapy in the experimental group for the trained and un-trained hands. Motor thresholds and silent periods evaluated with transcranial magnetic stimulation were differently modified by training in the two groups; although the changes in the input–output recruitment were similar. Conclusions: This pilot study suggests that movement imitation therapy enhances the effect of motor practice in patients with Parkinson's disease; imitation-training might be helpful for reducing hypometria in these patients. These results must be clarified in future larger trials. Highlights: Motor imitation training enhances the effect of motor practice in Parkinson's disease. Motor imitation training reduces hypometria in Parkinson's disease. Motor imitation training modifies cortical excitability in Parkinson's disease. The effect of motor imitation training outlasts the period of training. Motor imitation training might be effective as complement for classical treatments.