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Title: Motor imagery as a potential tool for improvement of musculoskeletal function in physiotherapy practice
Author: Alenezi, Majid
ISNI:       0000 0004 7432 2563
Awarding Body: Bangor University
Current Institution: Bangor University
Date of Award: 2018
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Motor imagery (MI) is a cognitive simulation technique with increasing importance in psychology, sport psychology and applied therapeutic domains (Dickstein & Deutsch, 2007; Guillot & Collet, 2008; Moran, Guillot, MacIntyre, & Collet, 2012). MI can be described as executing specific actions/tasks mentally, without any bodily movement, by adopting different sensory modalities (e.g. Collet & Guillot, 2010; Cumming & Ramsey, 2008; Jackson, Lafleur, Malouin, Richards, & Doyon, 2001). In the last two decades, a considerable amount of work has been performed to introduce MI as an effective rehabilitation tool for motor function, especially in the neurorehabilitation setting (Braun et al., 2006; Dickstein & Deutsch, 2007; Malouin & Richards, 2013; Mulder, 2007; Schuster, Butler, Andrews, Kischka, & Ettlin, 2012; Zimmermann-Schlatter et al., 2008). Despite the accumulating evidence supporting the benefits of cognitive techniques (e.g. MI) for patients with various neurological conditions, relatively little attention has been paid to the effects of imagery applications on the musculoskeletal system (Pelletier, Higgins, & Bourbonnais, 2015a, 2015b; Snodgrass et al., 2014). Consequently, the general objective of this thesis is to explore the potential role of MI as a therapeutic tool to be used as an alternative or adjunct to the traditional physiotherapeutic exercise for musculoskeletal parameters. The thesis is written as a collection of research studies committed to the objective described above. Chapter 1 represents a review of the literature exploring the potential role of imagery in musculoskeletal rehabilitation. Although the review chapter shows encouraging findings from the recent literature, it reveals the need to improve and develop the existing imagery intervention protocols for muscle strength outcomes to be used as a physiotherapeutic tool. Based on this need, our thesis comprises two experimental studies examining imagery’s efficacy on maximal force production in larger muscle groups, which is relevant in physiotherapy practice. In addition, this thesis builds on the potential expansion of research activities using imagery in Arabic countries by translating the vividness movement imagery questionnaire (VMIQ-2) to the Arabic language. Chapter 2 describes outcomes of a randomised control study examining the efficacy of cognitive imagery training on hip abductor strength in healthy individuals. In the study, two newly developed imagery protocols with specific imagery modalities, namely kinaesthetic with visual (KIN+VI) and kinesthetic only (KIN), were used and compared with a control group (no practice). The results demonstrated the efficacy of the imagery intervention for increasing strength in the hip abductor muscles and emphasised superior outcomes for the combined protocol (KIN+VI) for strength gains. In addition, the study revealed the efficacy of the KIN+VI imagery intervention for improving imagery ability (vividness). Chapter 3 reports the results of the second experimental study, which examines the efficacy of imagery practice (using the KIN+VI protocol from study 1) on the maximal isometric strength and electrical activity (EMG) of hip abductors (i.e. the efficacy of the ipsilateral training effect and bilateral transfer effects) compared with exercise in healthy individuals. In this study, the results showed a significant ipsilateral increase in strength and EMG amplitude in the trained hip abductor muscles of the imagery group (KIN+VI), while the exercise group did not show considerable gains. In addition, this chapter reports a novel finding concerning a bilateral transfer effect occurring after unilateral imagery training of the tested muscle group, with no strength gains occurring following exercise training. Finally, this study shows a clear indication that the home-imagery intervention protocol should be favoured over the home-exercise training due to the higher level of commitment in the imagery group; this illustrates the possibility of using imagery practice as a self-management intervention. Chapter 4 reports on the translation and validation of the VMIQ-2 to Arabic among Arabic native speakers living in the United Kingdom and Saudi Arabia. The chapter provides information about the translation process, cognitive debriefing test and initial reliability of the VMIQ-2 Arabic version. The study used an advanced analytical procedure to evaluate factorial validity by employing Bayesian structural equation modelling (BSEM) for each country’s dataset. The findings of this study provide initial support for the newly translated VMIQ-2-A with adequate psychometric properties; hence, it represents the first imagery ability questionnaire that has been translated into Arabic. Chapter 5 provides a summary of the thesis findings and clarifies the novelty of the current thesis. In addition, it outlines the future implications of the findings from the application and research perspectives. Furthermore, this chapter addresses the strengths and limitations of the thesis. Finally, it presents the conclusion of the current work.
Supervisor: Kubis, Hans-Peter Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available