Mental imagery has been used for decades by elite athletes to achieve their best performance in competition. Although few people qualify the Olympics or play professional sports, everyone can benefit from the use of mental imagery to improve function in daily life.
What is mental imagery?
Mental imagery, also called motor imagery or visualization, is the act of cognitively reproducing a physical activity without any corresponding movements. Research studies looking at brain function show that learning a sequential task through motor imagery practice produces cerebral changes similar to those seen after physical practice of the same task.
Mental imagery techniques can be practiced from an external viewpoint (visual imagery - watching or visualizing the activity) or an internal viewpoint (kinesthetic imagery - feeling the movement of doing the activity). The use of kinesthetic imagery training has been recommended for use in PD rehabilitation because it promotes body awareness for motor learning and performance of actual movements; however, its effectiveness has not been well researched.
Does mental imagery improve function in people with PD?
A 2007 study by Tamir et al found that combining motor imagery and physical practice was more effective than only physical practice in reducing bradykinesia in people with PD. Subjects also showed higher gains in the mental and motor subsets of the UPDRS and improvement in activities of daily living.
A recent study by Abraham et al (2018), examining the use of Dynamic Neuro-Cognitive Imagery training (also known as The Franklin Method) in participants with mild to moderate PD showed improvement in mental imagery ability, disease severity, and motor and spatial cognitive functions after 2 weeks of training. These findings support the effectiveness of using imagery-based systematic methods to retrain movement and postural control in people with PD.
A literature review in 2017 (Caligiore et al) which investigated the therapeutic use of action observation therapy (watching an action on video and then performing the action observed) or motor imagery practice found that both of these approaches can improve motor abilities of people in the early stages of the disease.
Should I try motor imagery practice?
Although evidence supporting the most effective approaches for the use of mental imagery by people with PD is still needed, practicing motor imagery to improve function in everyday tasks is worth considering. Successful practice takes abstract thinking and visual spatial skills that will depend on the specific abilities of the person with PD. The advantages of motor imagery practice are many -- it is safe, does not require equipment and can be done anywhere.
Suggestions for Practice
Start with a simple task - eating with a fork, buttoning a button, or combing your hair.
Imagine the movement or task properly - Practice the task correctly or watch someone else perform the task so that you can develop a good mental representation of the movements and steps.
Make the imagery as vivid and realistic as possible -- Include all of the senses. Mental rehearsal and actual performance of the task should take you about the same amount of time.
Imagine a positive outcome -- visualize perfect performance.
Keep it short -- practice regularly but for brief periods of time (5 or 10 minutes).