Review Article

Action Observation and Motor Imagery: Innovative Cognitive Tools in the Rehabilitation of Parkinson’s Disease

Table 1

Summary table of studies on rehabilitation with “motor imagery” or “action observation” in Parkinson’s disease.

CitationGroupsAge (years)Duration
(years)
H&Y
Type of interventionDose of intervention
(m/d/w)
ResultsFU

Tamir et al. (2007) [39]Exper. = 12 PD67.4 ± 9.77.4 ± 3.1 
2.29 ± 0.4
Combination of imagery + PT >60/2/12Significant improvements for the Exper. group in TUG time (decrease 2.5 sec.), getting up from supine (decrease 1.5 sec.), and 360-degree turn. Significant improvement in UPDRS mental section (from 2.1 to 1.2 points). No
Control = 11 PD67.4 ± 9.17.8 ± 4.5 
2.31 ± 0.4
Only PTNo parallel changes in the control group.

Braun et al. (2011) [40]Exper. = 25 PD70.0 ± 8.05.2 ± 5.0 
Most < 3
PT + imagery60/1/6No significant differences between the groups. General trend in favour of Exper. group.No

Ajimsha et al. (2014) [41]Exper. = 32 PD 

Control = 33 PD
61.4 ± 2.6

60.8 ± 2.1
3.0 ± 0.6 
2-3
3.1 ± 0.5 
2-3
Autogenic training

PT
60/5/8Significantly greater improvement of UPDRS motor section in the Exper. group after training (51.78% versus 35.24%) and at FU (30.82% versus 21.42%).12 weeks

Pelosin et al. (2010) [66]Exper. = 10 PD with FOG 
Control = 10 PD with FOG
68.8 ± 4.1 

70.2 ± 6.8
11.6 ± 4.9 
2.1 ± 0.3
9.5 ± 3.7 
2.2 ± 0.3
Action observation
+ PT 
Landscape observation
+ PT
60/3/4Significant improvement in both groups of motor performance (UPDRS-III, TUG, 10 M-WT) and quality of life (PDQ-39) after training and at FU.
FOG-Q and number of FOG episodes significantly reduced in both groups after training, but only in Exper. group at FU.
4 weeks

Buccino et al. (2011) [67]Exper. = 7 PD 

Control = 8 PD
68 (59–80)   

73.5 (67.5–76.5)
7 (5–19)  
3 (2.5–4) 
9 (5.5–13.5)  
1.7 (1.5–2.3)
Action observation + PT  

PT only
Significantly greater improvements in Exper. group for UPDRS and FIM scores.No

PD = Parkinson’s disease, H&Y = Hoehn and Yahr stage, PT = physical therapy, TUG = time-up-and-go test, UPDRS = Unified Parkinson’s Disease Rating Scale, FOG = Freezing of Gait, 10 M-WT = 10-meter walking test, FOG-Q = Freezing of Gait Questionnaire, FIM = Functional Independence Measure Scale, FU = follow-up, and PDQ-39 = Parkinson’s Disease Questionnaire.