The Use of Motor Images to Increase Physical Activity in Sports and as a Method of Rehabilitation - Essay Example

Table of Content The use of motor imagery to improve motor performance in sports 6 Motor Imagery as a rehabilitation method for stroke patients 10 Conclusion 13 The use of motor imagery to improve motor performance in sports and as a rehabilitation method for stroke patients. Abstract Motor imagery can be defined as a dynamic mental process or state which enables an individual to stimulate or rehearse a particular action. This paper has examined the use of motor imagery to improve motor performance in sports and as a rehabilitation method in stroke. Through a review of various relevant literatures, it is established in this paper that there is a positive link between the use of motor imagery and improved motor performance in sports and post-stroke rehabilitation. However, the existing studies in this area are limited since they are heterogeneous in nature and have not established the underlying mechanisms involved during motor imagery. As a result, there is need for further research in future so as to enhance the conclusiveness of these studies. Introduction Motor imagery can be defined as a dynamic mental process or state which enables an individual to stimulate or rehearse a particular action. This implies that during this mental state or process, an individual feels as if they are performing a particular action, however the action is imagined and not literal (Decety, 1996). Motor imagery can also be viewed as a technique that is used in various sports to improve motor performance and in the rehabilitation of patients with neurological conditions (Weinberg, 2008; Decety, 1996b). Over the years, a number of studies have been conducted to examine the role that motor imagery plays in improving motor performance in sports and in the rehabilitation of stroke patients. A good number of these studies have established a positive link between the use of motor imagery and improved motor performance. Nevertheless, some studies depict the limitations associated with the use of motor imagery to enhance motor performance in sports and its use in the rehabilitation of stroke patients (Defrancesco & Burke, 1997; Sharma et al, 2006). This paper will examine the use of motor imagery to improve motor performance in sports and as a rehabilitation method in stroke patients. Methodology The findings of this study will mainly be based on secondary data. Secondary data refers to data that has already been collected and recorded in other sources (Newman and Benz 1998). The findings of this paper will be established through a critical review of relevant literature from scientific journals, books and academic articles. Subsequently, the information collected will undergo a data analysis process. Data analysis can be defined as process through which data collected is organised and assessed so as to extract useful meaning. Most of the data collected in this study will be qualitative nature. This data will be evaluated to derive useful meaning using a data analysis technique referred to as the grounded theory. According to the grounded theory, data collected will be evaluated without any preconceived theory (Newman and Benz 1998). Therefore, the information retrieved from various literature sources will be analysed distinctively and relevant conclusion drawn. Applications An overview of motor imagery As established earlier in this paper, “motor imagery is a dynamic state or process during which representations of a particular motor action are rehearsed internally in working memory devoid of any overt motor output” (Decety, 1996b). To date, motor imagery has become a widely used technique that is used to carryout neurological rehabilitation in stroke patients and in improving motor learning. The effectiveness of this technique has been demonstrated in numerous studies (Defrancesco & Burke, 1997; Sharma et al, 2006). Decety (1996b), observes that there exists substantial evidence from various behavioural and neurophysiological sources showing that motor imagery, relates to similar processes involved in the programming and preparation of actual processes. Similarly, a number of studies suggest that motor imagery is a neuronal process that incorporates particular brain structures. The brain structures in question are involved in facilitating actual movements that are mediated by specific sensory-motor regions. Studies conducted by Roth et al (1996) and Decety et al (1994) show that motor imagery activates neural circuits of the brain that are involved in the initial stage of motor control or programming. These neural circuits include; the supplementary motor area, the basal ganglia, the primary motor cortex, the cerebellum and the inferior parietal cortex. In a study conducted by Lotze & Halsband, (2006), it was established that patients with Parkinson’s disease and patients with lesions in the motor cortex exhibited lesser movement as compared to patients with spinal lesions. From this study it is evident that during motor imagery, the imagination process is not influenced by the ability to execute movement instead this process is dependent on central processing mechanisms (Lotze & Halsband 2006). Functional neuroimaging research studies suggest that the motor system is not solely involved in the facilitation of movements. The motor system is also involved actively in the higher-level cognitive features of movement. This implies that the motor system can embody movements physiologically activating particular parts of the motor system without instigating any kind of movement. The activation pattern through motor imagery often involves structures that are directly involved in the process of motor execution such as the cerebellum, basal gangalia, posterior parietal cortex, premotor cortex, anterior cingulated and the inferior frontal cortex. It is worth noting, that the degree of involvement of these regions varies (Lotze & Halsband 2006). Several studies have examined the roles of these cortical motor regions in different motor imagery tasks (Dilda et al 2007). These studies show that the brain has specialised regions that receive input and make responses. For instance, the primary sensory cortex receives and interprets sensory inputs. The primary motor cortex is responsible for making the appropriate responses. The motor and sensory regions of the cortex are not the only areas responsible for sensation and movement, several cortical and sub-cortical regions are also involved. Basically, movement takes place when muscles of particular regions of the body contract. This is often instigated by motor neurons which express potentials from spinal cord to the muscles. Cell bodies of motor neurons are based in the pathways of the brain leading to the spinal cord. In addition to this, regions in the brain that are involved in control movement include; the Cerebellum, Parietal lobes, sub-cortical structures of basal ganglia and the frontal lobes of the cortex(Collet & Guillot, 2010; Porro et al , 1996). The figure below provides an elaborate example of brain regions involved in facilitating sensation and movement through motor imagery. American Medical Association The use of motor imagery to improve motor performance in sports The use of motor imagery in sports incorporates the use of senses to create and recreate experiences in the mind. Basically, sports comprises of both physical and mental aspects, these aspects play a critical role in enhancing sports performance. Motor imagery taps into the mental aspects of sports in order to facilitate physical responses. Over the years, many studies and theories have been formulated to examine the role that imagery plays in improving motor performance in sports. For instance, a study carried out by Defrancesco and Burke (1997) examined the use of motor imagery for preparation among professional tennis players. The study involved 115 female and male professional tennis players. The findings of this study depicted that imagery is one of the commonly used strategy by these tennis players during their preparatory routine. Coaches encourage their athletes to use imagery in order to help them learn new skills and to improve their motor skills. Furthermore, imagery is incorporated in their mental training programs (Defrancesco and Burke 1997). Research studies on imagery also suggest that motor imagery is frequently used and can be effective in bio-informational motor skills. For instances, shooters and archers frequently use motor imagery in the course of their training as well as during the concentration phrase just before they pull the trigger. The quality of images that they visualise highly influences their subsequent performance (Collet & Guillot, 2010). Athletes predominantly employ repetitive kinaesthetic imagery for training in order to improve performance. Through repetitive activation of motor networks characteristic for movement sequence, strengthening of synaptic transmission is made possible in the same way it is done in motor execution training (Sakamoto et al, 1987). Mental practise enhances performance in athletes. Roure et al (1999) and Driskell et al (1994), have established a positive correlation between the rating of a quality imagery through the use of changes in autonomic measures such as respiratory frequency, skin conductance and heart rate and the performance improvements of volleyball. Better imaging contributes to better training impacts of mental practice. Hence professional players employ imagery strategies more often than amateurs (Cumming and Hall, 2002). There is ample evidence that motor imagery helps to enhance performance. A study conducted by Guillot et al (2009) was devised to investigate the impact of motor imagery on the learning of tactical strategies in basketball among 10 female national basketball players. In the course of a pre-test, three attack movements were subjectively and objectively evaluated. The initial game strategy was mentally and physically practiced two times a week for a period of six weeks. The second strategy was physically performed whereas the third strategy was not trained. The graph below represents the scores of the athletes awarded by the coach after practise session using Motor Imagery (MI), Physical Practise (PP) and Control Condition (CONT). MI – Motor Imagery PP- Physical Practice CONT- Control Condition It was established that the combination of physical practise and motor imagery significantly improved motor performance in the course of the post-test. Scores that were awarded by the coach indicated that such as combination was the most efficient and effective training condition. Nonetheless, motor imagery was not found to be substantially more efficient than the use physical practise alone. Therefore, these results support the premise that motor imagery may contribute to improved motor performance in open skills when comparisons are made with the no-practise. Nevertheless, there is need for additional research in order to establish more conclusive findings. Based on the findings of this study, Guillot et al recommends that motor imagery should be considered as an alternative technique to prevent overtraining or minimise physical training (Guillot et al, 2009). Currently, it is debated to what extent brain networks are activated during motor imagery particularly with regards to the preparation and execution of motor acts. Various brain mapping techniques have been used to determine which brain networks are involved and how they help to execute motor performance. Early studies investigating the blood flow levels of cerebral regions using Positron Emission Tomography (PET) techniques showed that during Motor Imager motor-related regions such as lateral frontal (premotor) areas, supplementary motor area and the cerebellum were activated. Nevertheless, these did not give evidence of increased activity in the primary sensory motor cortex (Fox et al., 1987; Decety et al., 1990). Over time, conflicting results have been established using PET techniques and Functional Magnetic Resonance Imaging (FMRI) mapping studies. For instance, Lang et al (1994), using the PET technique established the activation of foci around the primary motor region during motor imagery. Furthermore, in a study conducted by Stephan et al. (1995), two out of six subjects portrayed the activation of the foci near the anterior area of the central sulcus which is a possible site of the primary motor cortex. However in studies conducted using the FMRI, the activation of the primary sensorimotor cortex was not established (Rao et al., 1993; Sanes et al., 1993). Some studies which used the FMRI, established the activation of the primary sensorimotor cortex in some subjects whereas in some the activation of the primary sensorimotor cortex was not established. (Leonardo et al., 1995; Sabbah et al., 1995). Motor Imagery as a rehabilitation method for stroke patients Stroke, also referred to as cerebrovascular accident (CVA) can be defined to as a condition characterised by a rapid loss of brain function as a result of disturbance in blood supply to the brain (Sims & Muyderman, 2009). Stroke is one of the major causes of functional disability and impairment. Motor dysfunction or impairment is one of the recurrent consequences of stroke. A stroke massively distorts the capacity of the brain to process neural messages. It is estimated that after an acute stroke, over 80% of patients succumb to some form of motor dysfunction. Approximately 20% of these patients recuperate and regain back their lost motor functions thus the remaining population of stroke patients are left with chronic motor disorders. Some of these include; balance related impairments, co-ordination and timing impairments, spasticity in some limbs and the loss of strength. Basically, these motor impairments compromise the quality of life after stroke. It is therefore essential for much therapeutic effort to be directed towards functional recovery of motor performance after stroke (Hendricks et al, 2002; Barker & Mullooly, 1997). Motor imagery is one of the valuable methods used in the rehabilitation of motor function after stroke. A number of studies show that the use of motor imagery has positive impact on motor performance after stroke. Some of these studies demonstrate that in the course of motor imagery sessions brain areas are activated just as during functional tasks (Gerardin et al, 2000; Hanakawa et al, 2003). Using brain mapping techniques, a number of studies have established that in the course of motor imagery, brain regions with links to motor execution were activated. Some of the regions activated in the course of imagery and also during the execution of motor movement include; the prefrontal cortex, the supplemental motor area, the pre-motor cortex , the cingulate cortex, the cerebellum and the parietal cortex. Some studies have established the activation of the primary motor cortex using FRMI experiments however other studies show the activation of this region is absent (Porro et al, 1996; Rao et al., 1993). A study conducted by Page et al (2001) was the initial randomised controlled study that established that, following a motor imagery intervention, stroke patients could improve their motor abilities. In this study, 13 stroke patients received a one hour physical therapy, three times every week in the course of a six week period. Among these patients, eight patients underwent additional motor imagery training whereas the remaining five patients underwent a control intervention involving an exposure to basic information on stroke. For both groups of stroke patients, the contact time was the same. Following this study, Page et al established that patients who underwent motor imagery training showed significant improvements in the motor improvement tests than patients in the control group (Page et al, 2001). It is worth noting, that the patients in this study were all early stroke patients varying between 2 to 11 months after the strokes. As a result, it is worth questioning whether motor training in this case helped to improve motor performance. In a different study conducted by Page et al (2005), six one year post- stroke patients underwent motor imagery training combined with physical therapy for 6 week. The performance of these patients in hand function was compared with that of patients in a control group who underwent physical therapy and relaxation training. The findings of this study showed that the daily arm use and arm function for the group that underwent motor imagery training and physical therapy had improved more than that of the control group which received relaxation training and physical therapy. This study confirms that motor imagery can help to improve motor functions even after a one-year post stroke period (Page et al, 2005). If motor imagery training brings about significant changes in motor performance as depicted in some study, it is plausible to conclude that at the neural level, reorganization takes place similar to one that is created during an actual motor functioning. There are few research studies that show imagery-related neural reorganization. For instance, a study conducted by Pascual-Leone et al (1995), established that motor imagery for finger movements leads to a similar neural reorganizational changes as the actual physical practice. Similar studies have reported the same changes in the cerebellum during both physical and mental practise. Future developments on the topic The literature reviewed in this paper shows that motor imagery can be a valuable method for post-stroke rehabilitation. Nevertheless, the underlying mechanisms involved during motor imagery have not been fully established. Despite the fact that the underlying mechanisms have not been fully established, it is apparent that motor imagery relies on the same neural processes as actual motor performance. It is therefore essential for future research studies to focus on the role of the primary motor cortex in motor recovery and convert action representation processes. The literature reviewed have also showed that neural reorganization that take place during motor imagery is similar to that which take place during physical practice (Vries & Mulder, 2007). The first clinical studies conducted suggest that motor imagery contribute to motor recovery in positive way after early stroke and after chronic stroke. Nevertheless, the current studies for post-stoke motor recovery are limited. The designs of a good number of clinical studies on motor imagery are very heterogeneous. In addition, most of these studies use very small-size samples sizes. Hence, it is not possible to draw general conclusion on the use of motor imagery for post-stroke rehabilitation. It is thus essential for future studies to employ large-size results in order to establish accurate and conclusive results. In addition, most of the studies conducted on this topic have not explored the relation between imagery ability and motor recovery (Vries & Mulder, 2007). Therefore, future developments on this topic should focus on examining the relation between imagery ability and motor recovery. Conclusion This paper has examined the use of motor imagery to improve motor performance in sports and as a rehabilitation method for stroke patients. Motor imagery can be defined as a dynamic mental process or state which enables an individual to stimulate or rehearse a particular action. A number of studies have been conducted to examine the role that motor imagery plays in improving motor performance in sports and in the rehabilitation of stroke patients. These studies have established a positive link between the use of motor imagery and improved motor performance and the effectiveness of motor imagery in post-stroke rehabilitation. The literature reviewed in this paper show that neural reorganization that take place during motor imagery is similar to that which take place during physical practice (Vries & Mulder, 2007). In sports, motor imagery taps into the mental aspects of sports in order to facilitate physical responses. 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