Objective: To compare the effects of an experimental intervention (EI) based on DNI with a control intervention (CI) of equal volume and intensity, excluding MP and focusing solely on PP.

Background: Freezing of gait (FOG) is a debilitating symptom of Parkinson’s disease (PD) that impacts quality of life. Mental practice (MP) is an emerging neurorehabilitation approach, and Dynamic Neuro-Cognitive Imagery (DNI), which combines MP and physical practice (PP), is a promising new technique.

Method: A single-blind, randomized, controlled clinical trial with 53 individuals (mean age 57.6 years) diagnosed with idiopathic PD, who were randomly allocated into the Experimental Group (EG) and Control Group (CG). Inclusion criteria required participants to use dopaminergic medication, show a positive response to the New Freezing of Gait Questionnaire (NFOG-Q), be able to ambulate independently at home, have internet access, and agree to participate. Exclusion criteria included neurological, cardiovascular, or respiratory disorders, severe cognitive deficits, or inability to perform motor imagery during the Kinesthetic and Visual Imagery Questionnaire-20 (KVIQ-20). Assessments and interventions were remotely conducted via video conferencing, with each participant undergoing 10 training sessions lasting 45-60 minutes. Three assessments were made: before intervention (BI), after (AI), and 30 days post-intervention as a follow up (FU). FOG was evaluated using the NFOG-Q, the Rapid Turn Test, and the Percentage of time spent with FOG (%FOG). Statistical analysis was performed using repeated-measures ANOVA based on permutation, and data imputation was used for missing values due to participant dropouts.

Results: Forty-four participants completed the intervention and reassessment. Both groups showed significant reductions in the NFOG-Q (p < 0.001), but only the EG maintained sustained improvements over time. The Rapid Turn Test revealed significant effects between groups (p < 0.0054) and assessments (p < 0.0006), with the CG showing higher scores than the EG at FU (p = 0.0032). The %FOG showed significant effects for group (p = 0.020), time (p < 0.001), and group x time interaction (p < 0.001), with the GC showing increased FOG at FU, while the EG maintained stable levels.

Conclusion: Both remote interventions improved FOG, but only EI ensured lasting severity reduction, indicating its potential as a treatment for PD.

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