Rhythmic Cued Motor Imagery in People With Multiple Sclerosis: Effects and Mechanisms

Journal

Multiple sclerosis (Houndmills, Basingstoke, England)

Year

2016

Abstract

Background: Our previous study showed that music and metronome cued motor imagery with verbal cueing improved walking, fatigue and quality of life (QoL) in people with multiple sclerosis (MS). However, the mechanisms of rhythmic cued motor imagery interventions have not yet been investigated in this population. Objectives: Aims of this study were to explore the motor imagery ability in people with MS and to compare the effects of differently cued motor imagery. Methods: A pilot study in 15 adults with MS and Expanded Disability Status Scale scores of 1.5-4.5 was conducted at the MS Clinic Innsbruck, Austria. Participants were randomised to one of three groups, 1. music and verbal cueing or 2. music only cueing and 3. no cueing. Participants were asked to practice 17 minutes of motor imagery 6 times per week, for 4 weeks. Participants were called weekly for support. Primary outcomes were motor imagery ability (Kinaesthetic and Visual Imagery Questionnaire, KVIQ-G-10, Time-Dependent Motor Imagery screening test, TDMI) and gait synchronisation with music beat (video-assisted gait analysis). Further, walking speed (Timed 25-Foot Walk), walking distance (6-Minute Walk Test, fatigue (Modified Fatigue Impact Scale), and QoL (Multiple Sclerosis Impact Scale-29) were assessed. Results: All participants were able to perform motor imagery as shown by median KVIQ-10 scores of 40 (26-50). On the TDMI, a very strong positive correlation between the number of imagined stepping movements within three different time periods (15, 25 and 45 seconds) was observed (Pearson's r= 0.85-0.88). Gait synchronisation with fast (110 beats per minute, BPM), but not slow (75 BPM) music beat was increased after music and verbally cued motor imagery as indicated by reduced step length and step time variability. However, the ratio of the music tempo expressed in BPM over the gait cadence improved similarly in all groups. Walking speed, walking distance, fatigue and QoL results were comparable to our previous study. Participants reported that they appreciated the support and well accepted the interventions. All participants completed the study. Conclusions: Findings from this pilot study showed that people with mild to moderate MS were able to motor image. Cueing might influence the synchronisation between cues and imagined steps, which could be transferred to actual walking. A larger study seems feasible, requiring a sample size of 20 per group, based on group differences in walking distance.

Music and Health Institute Terms

Fatigue; Gait; Mobility; Multiple Sclerosis; Neurodegenerative Disorders; Observational Measures; Physical Exercise; Rhythmic Auditory Stimulation; Recreative Music Methods; Subjective Measures

Indexed Terms

imagery; multiple sclerosis; Austria; clinical article; controlled clinical trial; controlled study; EMBASE keywords; Expanded Disability Status Scale; fatigue; Fatigue Impact Scale; foot; gait; hospital; human; participant observation; pilot study; quality of life; questionnaire; randomized controlled trial; sample size; screening test; six minute walk test; videorecording; walking speed

Study Type

Randomized Controlled; Trial; Quantitative Methods

Document Type

Article

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