Motor imagery training in older adults

...does it improve balance, mobility and falls?

As we age, deteriorations in balance and mobility contribute to disability, falls and mortality--all of which places greater strains on the healthcare system.

Allied health professionals such as physiotherapists are faced with increased geriatric admission rates and workload pressures to ensure adequate rehabilitation for their older patients via targeted balance, strength and functional training.

Some groups are harder to deliver an adequate training stimulus to, such as those with medically enforced restrictions on mobility or those who are afraid to continue exercise without supervision.

Motor imagery involves imagining undertaking a physical action but without actually physically executing the action. This activates regions of the brain that are normally activated during actual task performance.

Some studies have shown that this repeated mental rehearsal of a movement task improves subsequent physical performance of the task. Clinically relevant benefits have been obtained from motor imagery when used in various neurological patient groups (like stroke or Parkinson's disease), but only recently has the evidence about motor imagery in older people without neurological conditions been complied.

Pooling the available evidence showed that motor imagery training can significantly improve balance and gait speed. It also reduced the time it took for the study participants to stand up from a chair, walk 3 metres, turn around, walk back and sit down.

Although the review confirmed that the average effect of motor imagery was beneficial on those outcomes, it remains uncertain whether patients would consider that the magnitude of the benefit obtained was worth the time and effort involved.

However, if a patient is motivated to use their time to do this sort of mental rehearsal, then the review indicates that they have nothing to lose. Therefore, motor imagery training is an attractive option for patient groups that require motor task enhancement but are unable to complete traditional physical training interventions due to illness, surgical restrictions or enforced immobilisation.

> From: Nicholson Vaughan et al., J Physiother 65 (2019) (Epub ahead of print). All rights reserved to Australian Physiotherapy Association. Click here for the online summary.

Want to read deeper into this topic? Have a look at the free full text version of this article published in Journal of Physiotherapy!

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