Docstoc

Normal Aging and Motor Imagery Vividness:Implications for Mental

Document Sample
Normal Aging and Motor Imagery Vividness:Implications for Mental Powered By Docstoc
					NORMAL AGING AND MOTOR IMAGERY
VIVIDNESS:IMPLICATIONS FOR MENTAL
PRACTICE TRAINING IN REHABILITATION

   France Malouin , PhD
   Carol L. Richards, PhD
   Anne Durand, PhD
   Arch Phys Med Rehabil Vol 91, July 2010
    1

   報告者: 康富傑
   指導教授: 蔡佳良
OUTLINE
   Introduction
     Background
     Purpose

   Method
     Participants
     Study design

 Result & Discussion
 Study limitation

 Conclusion


                        2
BACKGROUND
   Motor imagery is an active process during which the
    representation of an action is internally reproduced within
    working memory without any overt output.
                                                               (Decety & Grezes, 1999)



   Mental practice through motor imagery has proved beneficial
    as an adjunct therapy for improving motor function after
    stroke, brain and spinal cord injuries, parkinson’s disease.
                   (Dickstein & Deutsch, 2007; Jackson et al., 2001)




                                                                                     3
Motor imagery: 綠色框框
                      4
BACKGROUND
   Motor imagery activates brain networks that greatly
    overlap with those activated by real movement.
                                   (Decety, 1995; Szameitat & Sterr, 2007)




   The neurocognitive studies have been largely
    documented in young healthy adults but few studies in
    elderly adults.
                              (Personnier et al., 2008; Skoura et al., 2005)




                                                                               5
BACKGROUND
   Aging has selective effects on motor imagery:
        Accessing and activating stored visual memories are
         particularly deteriorated in the elderly.
                                                           (Briggs, 1999)
        Age-related deficits are likely associated with decline in
         working memory.
                                                   (Dror & Kosslyn, 1994)
        Aging affect on the ability to generate vivid image of
         movement.
                                                      (Mulder et al., 2007)




                                                                              6
PURPOSE
   Investigated the influence of normal aging on the
    vividness of motor imagery and working memory
    (visuospatial, kinesthetic, verbal).

   It was postulated that deficits in motor imagery
    vividness would be accompanied by a corresponding
    decline in working memory.




                                                        7
OUTLINE
   Introduction
     Background
     Purpose

   Method
     Participants
     Study design

 Result&Discussion
 Study limitation

 Conclusion


                      8
PARTICIPANTS
   Included 80 healthy
    persons:
       The 3 groups are divided
        according to recently in the
        Mulder et al. study.

       The sample was a
        convenience sample
        including participants who
        had take part in a previous
        study on the validation of the
        KVIQ.

                                         9
PARTICIPANTS
   Inclusion criteria:
     Recruited in the university and rehabilitation center.
     Physically active and in good physical and mental health as
      determined by Health Status Questionnaire
   Exclusion criteria:
     Affect sensory input (eg, DM, BURN)
     Immobilization over the last 6 month (eg, fracture, sprain)
     Take medicine affecting the level of attention and alterness




                                                                     10
STUDY DESIGN
   motor imagery test
       Evaluation by KVIQ
         First a questionnaire about
          motor imagery experience
          was answered.
         Education level




                                        11
MOTOR IMAGERY TEST

   Kinesthetic and visual imagery questionnaire (KVIQ)
       visual and kinesthetic motor imagery.
       20 items (10 movement in each subscales) representing
        gestures with different body parts. 5 point scale.
       KVIQ test-retest reliability of the KVIQ has been confirmed
        in person with stroke and age-matched healthy persons with
        intraclass correlation coefficients rage from 0.81 to 0.90.
       Internal consistency has Cronbach alpha: 0.87 to 0.94
       KVIQ to promote motor imagery (internal perspective of
        first-person perspective)
                                                  (Malouin et al., 2007)

                                                                           12
KVIQ-20




          13
KVIQ-20




          14
STUDY DESIGN
   working memory test (WMT)
     Three domain were assessed: visuospatial, verbal, and
      kinesthetic.
     The examiner presented a series of items and asked the
      subject to reproduce it immediately. Items are taking
      randomly and present constantly.
     Standard procedure from: A compendium of
      neuropsychological tests. 2nd edition.




                                                               15
WORKING MEMORY TEST (WMT)
   In visualspatial condition:
       examiner tapped on a series of 9 blocks and asked subjects
        to imitate immediately.
   In verbal condition:
       examiner said a set of 9 words and asked subject to copy it.
   In Kinesthetic condition:
     subject (blindfold)
     examiner produced passively a series of posture or
      movement then asked subject to imitate.


                                                                       16
WORKING MEMORY TEST (KINESTHETIC)




                                    17
DATA ANALYSIS
   KVIQ
       maximum=50
           visualspatial: 10x5 ; kinesthetic: 10x5
       averaged using total score from each subscale
   WMT
       the performance converted into the percent of the maximal
        possible score and averaged




                                                                    18
DATA ANALYSIS
   Motor image:
       Repeated measures ANOVA for 2 factors
         Group: young, immediate, elderly
         Imagery modality: visual, kinesthetic

       Post hoc
           Bonferroni procedure
   Working memory ability:
       One-way ANOVA
           Group: young, intermediate, elderly




                                                  19
DATA ANALYSIS
   Relationship between visual and kinesthetic imagery &
    Relationship between age and working memory
       Pearson product-moment correlation


   Significant level was set at .05.




                                                            20
OUTLINE
   Introduction
     Background
     Purpose

   Method
     Participants
     Study design

 Result & Discussion
 Study limitation

 Conclusion


                        21
KVIQ DATA FINDING
   Visual imagery score
    higher than kinesthetic
    score in young (P= .005) ,
    intermediate (P=.001) but
    not in elderly (P=.427)




                                 22
KVIQ DATA FINDING
   The strongest relationship
    (r=.68, P<.010) was found
    in the elderly group and
    the lowest (r=.01, P>.10) in
    intermediate group, in
    young (r=.33, P>.10)




                                   23
KVIQ DATA FINDING
   Find from KVIQ , motor imagery does not diminish with
    age, but its quality change.
     In elderly group, the dominance of visual motor imagery
      lessens with aging, resulting in motor imagery modality
      equivalence.
     In healthy adults visual motor imagery dominance is a
      robust trait of motor imagery even after stroke.
                                              (Malouin et al., 2007, 2008)
       Intermediate group also had visual motor imagery
        dominance.


                                                                             24
WMT DATA FINDING
 visuospatial       working
  memory:
     Young group had higher
      visuospatial memory scores
      compared with the intermediate
      group (P=.011) and the elderly
      group (P=.001)

 kinesthetic       working
  memory:
     Mean score in young group were
      larger (P=.010) than those in the
      elderly group only.

 verbal    working memory:
     There was no group effect
      (F2,77=.38, P=.26)
                                          25
WMT DATA FINDING
   Compare to the young
    group:
     Intermediate group had
      difference in visual item
     Elderly group had
      difference in visual and
      kinesthetic item
     There were no difference
      in Verbal item



                                  26
WMT DATA FINDING
 Negative correlation
  between age and working
  memory
 Age-related decline was
  significant:
     Visuospatial (r=-.50,
      P<.001)
     Kinesthetic (r=-.34,
      P<.010)
     Not for verbal (r=-.17,
      P>.10)
                                27
WMT DATA FINDING
 A decline in working memory with increasing age
  (both three groups)
 Alternations in the quality of motor imagery could be
  linked to working memory deficits.
 This finding showing the role of working memory in
  relation with specific age effects for the generation and
  manipulation of mental image.




                                                              28
RESULT & DISCUSSION
 Motor  imagery involves cognitive processes to
 retrieve information from the long-term
 memory.
     This process needs a lot of attention and working
      memory loading, but is deteriorated in the elderly.
                                                 (Skoura et al., 2005)

        and prefrontal cortices activated during
 Frontal
 motor imagery play an important role in working
 memory.
     The elderly underrecruit these brain regions.
                                 (Jeannerod, 2001; Logan et al., 2002)
                                                                         29
RESULT&DISCUSSION
   The Findings that visuospatial working memory yields
    greater age differences than verbal or kinesthetic concur
    with earlier reports.
                      (Jordan, 1978; Jenkins et al., 2000; Verhaegen et al., 2002)




                                                                                     30
OUTLINE
   Introduction
     Background
     Purpose

   Method
     Participants
     Study design

 Result & Discussion
 Study limitation

 Conclusion


                        31
STUDY LIMITATION
   Compare to the VMIQ (visual modality from external
    seeing someone else) with aging, more difficult to
    imagine oneself than someone else.
       KVIQ (only discuss oneself)
                                            (Mulder et al., 2007)




                                                                    32
STUDY LIMITATION
   Although brain activation patterns during visual and
    kinesthetic motor imagery greatly overlap, f-MRI study
    revealed divergent patterns of activation.
      Visual imagery activated predominantly the occipital
       region and the superior parietal lobe.
      Kinesthetic imagery activated more the motor
       associated structure and the inferior parietal lobe.
                                              (Guillot et al., 2009)

   The visual motor imagery is more sensitive to aging
    maybe due to activate different neuro-pathway.

                                                                       33
STUDY LIMITATION
 KVIQ with simple movement , the result cannot be
  generalized to more complex tasks that would further
  load working memory especially in aging group.
 This study involves a minority of elderly subjects,
  cannot be generalized to all aging.




                                                         34
OUTLINE
   Introduction
     Background
     Purpose

   Method
     Participants
     Study design

 Result & Discussion
 Study limitation

 Conclusion


                        35
CONCLUSION
 Visual motor imagery dominance declines with age.
 Visual motor imagery is possibly more sensitive to aging
  than kinesthetic imagery .
 Age-related deficits in working memory are likely
  associated with a change in the quality of motor imagery
  with increasing age.




                                                             36
CONCLUSION
   In aging group:
     decreasing visual modality dominance
     decreasing in visuospatial and kinethetic working memory

   The cognitive status should be taken into account before
    introducing mental practice.




                                                                 37
     THANK YOU FOR YOUR ATTENTION.
38

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:2
posted:2/5/2013
language:Latin
pages:38