Effects of mental practice training associated with physical practice of gait in individuals with Parkinson's disease: protocol for a randomized trial
Parkinson Disease; Rehabilitation; Protocols; Neurological Gait Disorders.
Introduction: The mental practice (MP) is a cognitive strategy that enable serial mental training of a motor task without its physical implementation. This practice has been applied in a sort of neurological disorders rehabilitation and it has been revealed positive effects in planning and motor learning. Generally, individuals with Parkinson Disease (PD) show neurophysiological, motor and cognitive alterations since the disease progression makes necessary external strategies to assist the neuronal and motor organization. One of those strategies is the MP although there are no clear evidences in the literature about its applicability in PD patients yet. Therefore, the need arose to create protocols of effective and comprehensive trainings to direct and to introduce the best therapeutic approaches in clinical practice to optimize the PD patients’ rehabilitation process. Objective: To elaborate a MP training protocol associated with physical practice (PP) of gait on soil. In addition, to verify its appropriateness and applicability in PD individuals. Methods: It is a controlled, randomized and single blind clinic trial with 40 PD patients aged between 45 and 75 years, which have no cognitive deficit diagnosed, they are at a light to moderate stage of the disease and have the capacity to generate mental image. All participants will be evaluated by their cognitive level, physical disability level, mental image clarity, mobility and kinematic variables of gait on soil (spatiotemporal and angled). The individuals will be randomly distributed into experimental group (EG) and control group (CG). The EG will perform mental practice and physical practice of gate on soil. There will be held 12 training sessions of 1 hour in duration each, 3 times a week for 4 weeks. Then, one and seven days after the last training session, the patients will be revaluated by the kinematic variables of gait and mobility. Data analysis will be verified using Shapiro-Wilk. A ANOVA 2x3 repeated measures will analyse the interaction between the groups at some moments of observation. Results: The preliminary results reveal no significant differences between those groups. However, there is an intragroup (EG) difference about the support and swing total time of the most affected limb. Conclusion: The original protocol of MP associated with PP on PD individuals’ gait training demonstrated to be unfeasible.