Contributions
Abstract: P632
Type: Poster Sessions
Abstract Category: Therapy - Symptomatic treatment
Background: Walking impairment and fatigue are prevalent symptoms in people with multiple sclerosis (pwMS), which significantly impact on their quality of life (QoL). In our previous study, motor imagery (MI) with rhythmic auditory cueing has been shown to improve walking, fatigue and QoL in pwMS. So far, the underlying mechanisms are unclear.Objectives: To investigate the effects and mechanisms of differently cued and non-cued MI on walking, fatigue, QoL, MI ability and sensorimotor synchronisation (SMS) in pwMS, of gait to a fast and slow music beat.
Methods: Sixty pwMS with mild to moderate disability were recruited at the MS-Clinic, Innsbruck Medical University, Austria and randomised into one of three groups: music- and verbally cued MI (MVMI), music-cued MI (MMI) and MI. Participants were familiarised with (cued) MI and practised cued (MVMI/MMI) or non-cued MI of walking for 17 minutes, 6 times per week for 4 weeks in their homes. Primary outcomes were walking speed (Timed 25-Foot Walk) and walking distance (6-Minute Walk Test). Secondary outcomes were fatigue (Modified Fatigue Impact Scale), QoL (Multiple Sclerosis Impact Scale-29), MI ability (Kinaesthetic and Visual Imagery Questionnaire, KVIQ-10, Time-Dependent Motor Imagery screening test) and SMS (step length/time variability, stepwise synchronisation and absolute accuracy).
Results: Fifty-nine participants completed the study. All interventions induced significant improvements in walking speed (p=0.013) and distance (p=0.036) while MVMI was superior (p=0.024; p=0.001). After cued MI, there was a significant improvement in fatigue and QoL, with greatest changes in psychosocial fatigue (p=0.041) and physical QoL (p=0.005) after MVMI. All participants showed high MI ability and improved their MI ability post-intervention, as evidenced by median KVIQ-10 values of 4.1 (range 2.9-5.0) out of 5.0. Post-intervention, SMS was significantly more accurate in participants in the cued MI groups, as compared to those in the MI group (all p< 0.05). There were no adverse events and full compliance was observed.
Conclusions: Cued and non-cued MI improved walking although MVMI was the most effective intervention. Improvements in fatigue, QoL and SMS were induced only by cued MI whilst MVMI was superior. All participants were capable of imagining movements and improved the synchronisation of their gait with music only after a cued MI practice. Results suggest that MI and SMS were underlying mechanisms of action.
Disclosure: This study was supported by the Austrian MS Research SocietyBarbara Seebacher: Nothing to discloseRaija Kuisma: Nothing to discloseAngela Glynn: Nothing to discloseThomas Berger: Nothing to disclose
Abstract: P632
Type: Poster Sessions
Abstract Category: Therapy - Symptomatic treatment
Background: Walking impairment and fatigue are prevalent symptoms in people with multiple sclerosis (pwMS), which significantly impact on their quality of life (QoL). In our previous study, motor imagery (MI) with rhythmic auditory cueing has been shown to improve walking, fatigue and QoL in pwMS. So far, the underlying mechanisms are unclear.Objectives: To investigate the effects and mechanisms of differently cued and non-cued MI on walking, fatigue, QoL, MI ability and sensorimotor synchronisation (SMS) in pwMS, of gait to a fast and slow music beat.
Methods: Sixty pwMS with mild to moderate disability were recruited at the MS-Clinic, Innsbruck Medical University, Austria and randomised into one of three groups: music- and verbally cued MI (MVMI), music-cued MI (MMI) and MI. Participants were familiarised with (cued) MI and practised cued (MVMI/MMI) or non-cued MI of walking for 17 minutes, 6 times per week for 4 weeks in their homes. Primary outcomes were walking speed (Timed 25-Foot Walk) and walking distance (6-Minute Walk Test). Secondary outcomes were fatigue (Modified Fatigue Impact Scale), QoL (Multiple Sclerosis Impact Scale-29), MI ability (Kinaesthetic and Visual Imagery Questionnaire, KVIQ-10, Time-Dependent Motor Imagery screening test) and SMS (step length/time variability, stepwise synchronisation and absolute accuracy).
Results: Fifty-nine participants completed the study. All interventions induced significant improvements in walking speed (p=0.013) and distance (p=0.036) while MVMI was superior (p=0.024; p=0.001). After cued MI, there was a significant improvement in fatigue and QoL, with greatest changes in psychosocial fatigue (p=0.041) and physical QoL (p=0.005) after MVMI. All participants showed high MI ability and improved their MI ability post-intervention, as evidenced by median KVIQ-10 values of 4.1 (range 2.9-5.0) out of 5.0. Post-intervention, SMS was significantly more accurate in participants in the cued MI groups, as compared to those in the MI group (all p< 0.05). There were no adverse events and full compliance was observed.
Conclusions: Cued and non-cued MI improved walking although MVMI was the most effective intervention. Improvements in fatigue, QoL and SMS were induced only by cued MI whilst MVMI was superior. All participants were capable of imagining movements and improved the synchronisation of their gait with music only after a cued MI practice. Results suggest that MI and SMS were underlying mechanisms of action.
Disclosure: This study was supported by the Austrian MS Research SocietyBarbara Seebacher: Nothing to discloseRaija Kuisma: Nothing to discloseAngela Glynn: Nothing to discloseThomas Berger: Nothing to disclose