Objective: To compare the effects of an experimental intervention (EI) based on NCI with a control intervention (CI) of equal volume and intensity, differing only in mental practice components, on PD-related FOG.

Background: Freezing of gait (FOG) significantly impairs the quality of life in Parkinson’s Disease (PD). Mental practice (MP) is an emerging field in neurorehabilitation and Dynamic Neuro-Cognitive Imagery (NCI) is a new approach that combines MP with physical practice (PP). Despite limited research on NCI-based interventions, they are considered safe and effective for remote administration in individuals with PD.

Method: A randomized, controlled, double-blind trial with 23 participants, mean age 54, H&Y stages II/III, and about 17 years of schooling. Inclusion criteria included diagnosis of idiopathic PD, use of dopaminergic medication, at least one episode of FOG per day, ambulation without any orthosis or assistive device at home, internet access, and agreement to participate. Individuals with neurological, cardiovascular, or respiratory disorders, uncorrected visual or auditory impairments, severe cognitive impairments affecting verbal instruction comprehension, or inability to perform motor imagery during the Kinesthetic and Visual Imagery Questionnaire-20 (KVIQ-20) application were excluded. Assessments and interventions were remotely conducted via video conferencing, with each participant undergoing 10 training sessions lasting 45 minutes. All participants were assessed before (BT), after (AF), and 60 days post-training as follow-up (FU). FOG frequency, intensity, and impact on functionality were assessed using the New Freezing of Gait Questionnaire (NFOG), Rapid Turns Test, and Percentage of Time with FOG (%FOG).The results were analyzed by ANOVA for repeated measures considering group and evaluation as factors.

Results: Nineteen participants completed training and reassessment. The remote study protocol was feasible. Both groups exhibited reduced NFOG scores (p<0.0004), fewer FOG occurrences during the Rapid Turns Test, and a decrease in %FOG (p<0.036).

Conclusion: The study found both interventions positively impacted FOG episodes, motor aspects, functionality, and quality of life, with no significant difference between groups. This suggests remote MP delivery could be beneficial in reducing FOG’s impact on PD patients’ daily lives.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effects-of-mental-practice-on-fog-in-people-with-parkinsons-disease-a-randomized-clinical-trial/