11-2 Motor Imagery in Physical Therapy

Motor Imagery in Physical Therapy
Ruth Dickstein, P.T., Ph.D

Motor imagery is the mental representation of movement without the execution of body movement. The terms “motor imagery practice” or “mental rehearsal” refer to the training of motor imagery contents with the goal of improving motor performance.

Training by imagery, well established in sports, has recently been introduced into physical therapy and rehabilitation. Physical therapists who apply this form of training mostly use an integrated approach in which practice by imagery accompanies regular exercises. However, when real practice is not desirable or possible,  the application of motor imagery practice can be used by itself.

The two prevailing modes of motor imagery application are 1) visual imagery, by which the trainee watches himself performing the target movement(s), and, 2) somatosensory, mainly kinesthetic imagery which involves imagining the kinesthetic sensations that would be evoked by the imagined movement(s).

Interventions employed to achieve motor or task competence are largely comparable for real and imagined exercises; therefore, the same “rules” and concepts that underlie the formulation of exercise therapy for solving a clinical problem apply to imagery practice.  Yet, because of absence of external feedback, the therapist has to employ tracking and controlling routines to validate compliance with the imagery exercises. The results of brain imaging studies show that parallel brain areas are activated during real and imagined performance of the same motor task. In addition, motor imagery practice much like real practice contributes to functional brain reorganization both in healthy individuals and in patients with CNS lesions. 

The positive effects of motor imagery practice have been documented in numerous clinical trials. 

Key words: Motor Imagery, Mental practice, Mental rehearsal, Physical rehabilitation, Stroke.