Effects and mechanisms of differently cued and non-cued motor imagery in people with multiple sclerosis: A randomised controlled trial

Abstract

Background: Walking impairment and fatigue are prevalent symptoms in people with multiple sclerosis (PwMS). Motor imagery (MI) with rhythmic auditory cueing improved walking in PwMS, but so far, the underlying mechanisms are not fully explored.

Objective: This study investigated the effects and mechanisms of differently cued and non-cued MI on walking, fatigue and quality of life (QoL) in PwMS.

Methods: A total of 60 PwMS with mild to moderate disability were randomised to music- and verbally cued MI (MVMI), music-cued MI (MMI) or MI. Participants practised cued or non-cued MI of walking for 17 minutes, six times per week for 4 weeks at home. Primary outcomes were walking speed (timed 25-foot walk) and walking distance (6-minute walk test).

Results: A total of 59 participants completed the study. All interventions induced significant improvements in walking speed and distance, while MVMI was superior. After cued MI, fatigue and QoL significantly improved, with greatest changes seen after MVMI. All participants showed high MI ability. Post-intervention, sensorimotor synchronisation (SMS) was significantly more accurate after cued MI.

Conclusion: All interventions significantly improved walking. MVMI was superior in improving walking, fatigue and QoL. Results suggest that MI and SMS were mechanisms of action.

Keywords: Multiple sclerosis; cued motor imagery; fatigue; motor imagery ability; sensorimotor synchronisation; walking.