Enhancing Gait Initiation In Parkinson's Disease: Immediate Impact Of Motor Imagery And Action Observation Intervention

PURPOSE: Parkinson's Disease (PD) is associated with debilitating motor impairments that significantly increase the risk of falls. Gait initiation (GI) variability, a sensitive indicator of fall risk, is a critical focus for intervention in this population. Traditional rehabilitation approaches face limitations in addressing the challenges of gait initiation. Alternative therapies, including Action Observation (AO) and Motor Imagery (MI), show promise in neurological rehabilitation and emerge as compelling options, especially for individuals with limited mobility. This study explores the immediate impact of a single session of motor imagery and action observation intervention on gait initiation in individuals with PD. METHODS: Eighteen participants, comprising 9 individuals with PD (mean age: 76 years) and 9 age-matched Older Adults (OA) (mean age: 74 years), were enrolled in this investigation. Gait data were collected using the PKMAS Walkway before and after a 20-minute intervention session. The intervention featured MI and AO exercises tailored to enhance gait initiation. Step length (cm) mean and the coefficient of variability (CV) were analyzed to discern changes in gait performance. RESULTS: Preliminary analysis revealed improvements in both step length and step length CV among individuals with PD following the motor imagery and action observation intervention, as compared to OA. Specifically, individuals with PD exhibited a 9% improvement in step length from baseline, while OA demonstrated a 5% increase. Most significantly, the coefficient of variability in step length for PD substantially improved from baseline (8.5) to post-intervention (6.16) with a significance level of p = 0.049. CONCLUSIONS: Our findings underscore the potential of a brief session of MI and AO intervention, drawing upon alternative therapeutic modalities, to positively influence gait initiation in individuals with PD. This innovative approach holds promise as a more accessible avenue for rehabilitation, particularly for those with limited mobility. These immediate effects emphasize the clinical relevance of integrating alternative therapies into comprehensive PD rehabilitation strategies, offering a novel and practical approach to address the intricate challenges associated with PD.