Immediate Effect of Mental Practice on Performance of a Neurodynamic Skill in Physiotherapy Students: A Randomized Control Trial

  • Isha S. Akulwar Assistant Professor in Neurosciences Physiotherapy Institute: K. J. Somaiya college of Physiotherapy, Mumbai, India
  • Kajal Uday Chheda Institute: K. J. Somaiya college of Physiotherapy, Mumbai, India.
Keywords: Mental Practice, Neurodynamic skill, ULNT-1, OSPE, Physiotherapy education, RCT

Abstract

Background: Mental Practice (MP), "the cognitive rehearsal of a task in the absence of overt physical movement," has been used successfully in teaching and rehearsing complex psychomotor tasks in several domains, including sports; music; and recently, in surgical skills acquisition. This study investigates the implementation of MP on performance of a neurodynamic skill in third year undergraduate Physiotherapy students.

Method: It was a randomized control trial (single-blind) conducted in a Physiotherapy institute. A convenient sample of 40 III year undergraduate students who were novice for the topic were recruited. Some important preliminary steps involved development and validation of the tools used in the study viz. an audio script to guide mental imagery practice and an OSPE checklist to assess the outcome. The OSPE checklist was procedural specific for ULNT-1 and included stations for cognitive, psychomotor and affective domains. A neurodynamic skill (ULNT-1 Median nerve) was taught to all the students (n = 38, 2 drop outs) by a teacher as a didactic lecture followed by physical practice which was supervised and guided by the same teacher. After randomization, the intervention group (n=19) received MP guided by a structured audio script as a single session for 20 minutes delivered to all the participants together in a group. The control group participants (n=19) intended to serve as a basis of comparison and received no intervention. Pre- and post-intervention assessment was done by a set of examiners who were blinded to the intervention. Comparative analysis was done within the group using Wilcoxon sign rank test and between the groups using unpaired t test.

Results: MP group showed significant improvement in cognitive, psychomotor, affective domain and total score of OSPE post intervention whereas the control group did not show significant difference except for the total score. Between group comparison showed significant differences in all the domains and total score in favor of the MP group. Also, the extent of improvement (effect size calculated using Cohen’s d) was more in the mental practice group than in the control group.

Conclusion: MP as an adjunct to physical practice is a time-and cost-effective strategy to augment traditional training and enhance performance of a neurodynamic skill in Physiotherapy students. This preliminary evidence supported by robust scientific base and ease of integration should facilitate adoption of MP in Physiotherapy education. We recommend future studies to further explore the potential of this promising tool.

References

(1) Driskell JE, Copper C, Moran A. Does mental practice enhance performance? J Appl Psychol. 1994; 79(4):481-492.

(2) Schuster C, Hilfiker R, Amft O, et al. Best practice for motor imagery: a systematic literature review on motor imagery training elements in five different disciplines. BMC Med. 2011; 9:75.

(3) Taktek K. The effects of mental imagery on the acquisition of motor skills and performance: a literature review with theoretical implications. J Ment Imagery. 2004; 28:79-114.

(4) Feltz DL, Landers DM. The effects of mental practice on motor skill learning and performance: a meta-analysis. Journal of Sport Psychology. 1983; 5:25-27.

(5) Martin KA, Hall CR. Using mental imagery to enhance intrinsic motivation. Journal of Sports & Exercise Psychology. 1995; 17(1):54-69.

(6) Keller P. Mental imagery in music performance: Underlying mechanisms and potential benefits. Annals of the New York Academy of Sciences. 2012; 1252(1):206-213.

(7) Stefanidis D, Anton NE, Howley LD, Bean E, Yurco A, Pimentel ME, Davis CK. Effectiveness of a comprehensive mental skills curriculum in enhancing surgical performance: Results of a randomized controlled trial. The American Journal of Surgery. 2017; 213:318-324.

(8) Bachman K. Using mental imagery to practice a specific psychomotor skill. J Contin Educ Nurs. 1990; 21(3):125–128.

(9) Wulf G, Shea C, Lewthwaite R. Motor skill learning and performance: a review of influential factors. Med Educ. 2010; 44(1):75–84.

(10) Michels ME, Evans DE, Blok GA. What is a clinical skill? Searching for order in chaos through a modified Delphi process. Med Teach. 2012; 34(8):573–581.

(11) Raman M, Donnon T. Procedural skills education–colonoscopy as a model. Can J Gastroenterol. 2008; 22(9):767-770.

(12) Shacklock M. Clinical Neurodynamics: a new system of musculoskeletal treatment. 1st Ed. Elsevier: Health Sciences; 2005.

(13) Gelding RW, Thompson WF, Johnson BW. The Pitch Imagery Arrow Task: Effects of Musical Training, Vividness, and Mental Control. PLoS One.2015; 10(3):1-20.

(14) Brydges R, Carnahan H, Backstein D, Dubrowski A. Application of motor learning principles to complex surgical tasks: searching for the optimal practice schedule. J Mot Behav. 2007; 39(1):40-48.

(15) Weisinger H, Pawliw-Fry JP. Performing Under Pressure: The Science of Doing Your Best When It Matters Most. New York Times: Crown Publishing group; 2015.

(16) Parsons LM, Fox PT, Downs JH, Glass T, Hirsch TB, Martin CC, Jerabek PA, Lancaster JL. Use of implicit motor imagery for visual shape discrimination as revealed by PET. Nature. 1995; 375 (6526):54–58.

(17) Jeannerod M, Frak V. Mental imaging of motor activity in humans. Curr Opin Neurobiol. 1999; 9(6):735–739.

(18) Roth M, Decety J, Raybaudi M, Massarelli R, Delon-Martin C, Segebarth C, Morand S, Gemignani A, Decorps M, Jeannerod M. Possible involvement of primary motor cortex in mentally simulated movement: a functional magnetic resonance imaging study. Neuroreport. 1996; 7(7):1280–1284.

(19) Nyberg, L, Eriksson J, Larsson A, Marklund P. Learning by doing versus learning by thinking: an fMRI study of motor and mental training. Neuropsychologia. 2006; 44(5):711–717.

(20) Jeannerod M; Decety J. Mental motor imagery: a window into the representational stages of action. Current opinion in neurobiology. 1995; 5(6):727–732.

(21) Seidler RD, Bernard JA, Burutolu TB, Fling BW, Gordon MT, Gwin JT et al. Motor control and aging: links to age-related brain structural, functional, and biochemical effects. Neurosci Biobehav Rev. 2010; 34(5):721–733.

(22) Heuninckx S, Wenderoth N, Swinnen SP. Systems neuroplasticity in the aging brain: recruiting additional neural resources for successful motor performance
in elderly persons. J Neurosci. 2008; 28(1):91–99.

(23) Zwergal A, Linn J, Xiong G, Brandt T, Strupp M, Jahn K. Aging of human supraspinal locomotor and postural control in fMRI. Neurobiol Aging. 2012; 33(6):1073–1084.

(24) la Fougère C, Zwergal A, Rominger A, Förster S, Fesl G, Dieterich M et al. Real versus imagined locomotion: a [18F]-FDG PET-fMRI comparison. Neuroimage. 2010; 50(4):1589–1598.

(25) Jahn K, Deutschländer A, Stephan T, Strupp M, Wiesmann M, Brandt T. Brain activation patterns during imagined stance and locomotion in functional magnetic resonance imaging. Neuroimage. 2004; 22(4):1722–1731.

(26) Carpenter CB. Principles of Mental Physiology. 4th Ed. New York, NY: Appleton; 1894.

(27) Bird EI. EMG quantification of mental rehearsal. Perceptual and Motor Skills. 1984; 59: 899-906.

(28) Jowdy DP, Harris DV. Muscular responses during mental imagery as a function of motor skill level. Journal of Sports and Exercise Psychology.1990; 12(2):191-201.

(29) Gandevia SC, Wilson LR, Inglis JT, Burke D. Mental rehearsal of motor tasks recruits á-motoneurons but fails to recruit human fusimotor neurons selectively. Journal of Physiology. 1997; 505(1):259-266.

(30) Hashimoto R, Rothwell JC. Dynamic changes in corticospinal excitability during motor imagery. Exp Brain Res. 1999; 125(1): 75-81.

(31) Guillot A, Collet C. Duration of Mentally Simulated Movement: A Review. Journal of Motor Behavior. 2005; 37(1): 10-20.

(32) Harris DV, Robinson W. The effects of skill level on EMG activity during internal and external imagery. Journal of Sports and Exercise Psychology. 1986; 8(2):105-111.

(33) Bakker FC, Boschker M, Chung T. Changes in muscular activity while imagining weight lifting using stimulus or response propositions. Journal of Sport and Exercise Psychology. 1996; 18: 313- 324.

(34) Frank C, Land WM, Popp C, Schack T. Mental Representation and Mental Practice: Experimental Investigation on the Functional Links between Motor Memory and Motor Imagery. PLoS One. 2014; 9(4): e95175.

(35) Tod D, Iredale F, Gill N. 'Psyching-up' and muscular force production. Sports Med. 2003; 33(1):47-58.

(36) Ranganathan VK, Siemionow V, Liu JZ, Sahgal V, Yue GH. From mental power to muscle power- gaining strength by using the mind. Neuropsychology. 2004; 42(7):944-956.

(37) Yao WX, Ranganathan VK, Allexandre D, Siemionow V, Yue GH. Kinesthetic imagery training of forceful muscle contractions increases brain signal and muscle strength. Front Hum Neurosci. 2013; 7: 561.

(38) Stinear C, Byblow W, Steyvers M, Levin O, Swinnen S. Kinesthetic, but not visual, motor imagery modulates corticomotor excitability. Exp Brain Res. 2006; 168(1-2):157–164.

(39) Guillot A, Collet C, Vo Nguyen, Malouin, Richards C, Doyon J. Brain Activity During Visual Versus Kinesthetic Imagery: An fMRI Study. Human Brain Mapping. 2009; 30:2157–2172.

(40) Lorey B, Bischoff M, Pilgramm S, Stark R, Munzert J, Zentgraf K. The Embodied Nature of Motor Imagery: The Influence of Posture and Perspective. Exp Brain Res. 2009; 194(2):233-243.

(41) Slimani M, Tod D, Chaabene H, Miarka B, Chamari K. Effects of Mental Imagery on Muscular Strength in Healthy and Patient Participants: A Systematic Review. J Sports Sci Med. 2016; 15(3): 434–450.

(42) Mulder T, Hochstenbach JB, Van Heuvelen MJ, den Otter AR. Motor imagery: the relation between age and imagery capacity. Hum Mov Sci. 2007; 26(2):203-211.

(43) Hall C, Buckolz E, Fishburne GJ. Imagery and the acquisition of motor skills. Can J Sport Sci. 1992; 17(1):19–27.

(44) Kim JG, Chung ST. Auditory, visual, and kinesthetic imagery on badminton service learning and performance. Journal of Sport and Exercise Psychology. 1998; 20: 67.

(45) Pearson J, Naselaris T, Holmes EA, Kosslyn SM. Mental Imagery: Functional Mechanisms and Clinical Applications. Trends Cogn Sci. 2015; 19(10): 590–602.

(46) Bargh JA, Chen M, Burrows L. Automaticity of social behavior: direct effects of trait construct and stereotype-activation on action. Journal of Personality and Social Psychology. 1996; 71(2):230–244.

(47) Walinga J, Stangor C. Introduction to Psychology. 1st Ed. Canada: BC campus; 2014.

(48) Dadds MR, Bovbjerg DH, Redd WH, Cutmore TRH. Imagery in human classical conditioning. Psychological Bulletin. 1997; 122(1): 89–103.

(49) Bernardi NF, Buglio MD, Trimarchi PD, Chielli A, Bricolo E. Mental practice promotes motor anticipation: evidence from skilled music performance. Front Hum Neurosci. 2013; 7:451.

(50) Ghilardi MF, Moisello C, Silvestri G, Ghez C, Krakauer J. Learning of a Sequential Motor Skill Comprises Explicit and Implicit Components that Consolidate Differently. J Neurophysiol. 2009 May; 101(5): 2218–2229.

(51) Nakamura T, Ghilardi M F, Mentis M et al. Functional networks in motor sequence learning: abnormal topographies in Parkinson's disease. Hum. Brain Mapp. 2001;12(1):42–60

(52) Jeffrey RW, Bandura A. The influence of symbolic and motor rehearsal in observational learning. Journal of personality and social psychology. 1973; 26(1):122-130.

(53) Ericsson KA. Deliberate practice and the modifiability of body and mind: Toward a science of structure and acquisition of expert and elite performance. Int J Sport Psychol. 2007; 38(1): 4-34.

(54) Frank C, Land WM, Schack T. Mental representation and learning: The influence of practice on the development of mental representation structure in complex action. Psychol Sport Exercise. 2013; 14(3):353–361.

(55) Moulton ST, Kosslyn S. Imagining predictions: mental imagery as mental emulation. Philos Trans R Soc Lond B Biol Sci. 2009; 364(1521): 1273–1280.

(56) Beauchamp MR, Barling J, Morton KL. Transformational Teaching and Adolescent Self-Determined Motivation, Self-Efficacy, and Intentions to Engage in Leisure Time Physical Activity: A Randomized Controlled Pilot Trial. Applied Psychology: Health and Well being. 2011; 3 (2):127–150.

(57) Martin KA, Hall CR. Using mental imagery to enhance intrinsic motivation. Journal of Sport & Exercise Psychology. 1995;17(1)54–69.

(58) Weinberg RS, Gould D. Foundations of sport and exercise psychology. 4th Ed. United States: Human Kinetics, Champaign, IL; 2007.

(59) Weinberg R. Does Imagery Work? Effects on Performance and Mental Skills. Journal of Imagery Research in Sport and Physical Activity. 2008; 3(1).

(60) Vadoa EA, Hall CR, Moritz SE. The relationship between competitive anxiety and imagery use. Journal of Applied Sport Psychology. 1997; 9(2):241-253.

(61) Richardsan A. Mental Practice: A Review and Discussion Part I. Res Quarterly. 1967; 38(1): 95-107.

(62) Decety J. Do imagined and executed actions share the same neural substrate? Cognitive Brain Research. Elsevier. 1996; 3(2): 87–93.

(63) Libby LK, Shaeffer EM, Eibach RP, Slemmer JA. Picture yourself at the polls: visual perspective in mental imagery affects self-perception and behavior. Psychol Sci. 2007; 18(3):199–203.

(64) Malouin F, Richards CL, Durand A, Doyon J. Clinical assessment of motor imagery after stroke. Neurorehabil Neural Repair. 2008; 22(4):330–340.

(65) Holmes P, Collins D. The PETTLEP approach to motor imagery: A functional equivalence model for sport psychologists. J Appl Sport Psychol.2007; 13(1):60–83.

(66) Morrisett LN, Jr, The Role of Implicit Practice in Learning, unpublished doctoral dissertation: Yale University; 1956.

(67) Ryan ED, Simons J. Cognitive demand, imagery, and frequency of mental rehearsal as factors influencing acquisition of motor skills. Journal of Sport Psychology. 1981; 3(1):35-45.

(68) Sackett RS. The influence of symbolic rehearsal upon the retention of a maze habit. Journal of General Psychology. 2010; 376-398.

(69) Paivio A. Cognitive and motivational functions of imagery in human performance. Canadian Journal of Applied Sport Sciences. 1985; 10(4):22–28.

(70) Morris T, Spittle M, Watt AP. Imagery in sport. Champaign, IL: Human Kinetics.2005.

(71) Noorafshan A, Hoseini L, Karbalay-doust S, Mahmoodian H, Bazrafkan L, Rafati A. Make a Personal Anatomical Atlas in Your Mind with Mental Imagery and Improve Your Active Learning of Human Anatomy. Austin J Anat. 2016; 3(2):1050.

(72) Buegel HF. The effects of introducing ideational elements in perceptual-motor learning. Journal of Experimental Psychology. 1940; 27(2):111–124.

(73) Fitts PM, Posner MI. Human Performance. Brooks/Cole Pub. Co; Belmont, CA: 1967.

(74) Clark LV. Effect of mental practice on the development of a certain motor skill. Res Quart. 1960; 31(4):560–569

(75) Corbin C. Effects of mental practice on skill development after controlled practice. 2013; 38(4):534-538.

(76) Oxendine JB. Effect of Mental and Physical Practice on the Learning of Three Motor Skills, Research Quarterly. American Association for Health, Physical Education and Recreation. 2013; 40(4):755-763.

(77) Page SJ, Levine P, Leonard AC. Effects of mental practice on affected limb use and function in chronic stroke. Arch Phys Med Rehabil. 2005; 86:399–402.

(78) Dunsky A, Dickstein R, Ariav C. et al. Motor imagery practice in gait rehabilitation of chronic post-stroke hemiparesis: four case studies. Int J Rehabil Res. 2006; 29(4):351–356.

(79) Tod D, Edwards C, McGuigan M, Lovell G. A Systematic Review of the Effect of Cognitive Strategies on Strength Performance. Sports Medicine. 2015; 45(11): 1589-1602
Published
2021-02-10
How to Cite
Akulwar, I. S., & Chheda , K. U. (2021). Immediate Effect of Mental Practice on Performance of a Neurodynamic Skill in Physiotherapy Students: A Randomized Control Trial. European Journal of Applied Sciences, 9(1), 204-222. https://doi.org/10.14738/aivp.91.9266