title: Effects of movement imitation training in Parkinson's disease: A virtual reality pilot study.
abstract: Hypometria is a clinical motor sign in Parkinson's disease. Its origin likely emerges from basal ganglia dysfunction, leading to an impaired control of inhibitory intracortical motor circuits. Some neurorehabilitation approaches include movement imitation training; besides the effects of motor practice, there might be a benefit due to observation and imitation of un-altered movement patterns. In this sense, virtual reality facilitates the process by customizing motor-patterns to be observed and imitated.
  
  
  
  To evaluate the effect of a motor-imitation therapy focused on hypometria in Parkinson's disease using virtual reality.
  
  
  
  We carried out a randomized controlled pilot-study. Sixteen patients were randomly assigned in experimental and control groups. Groups underwent 4-weeks of training based on finger-tapping with the dominant hand, in which imitation was the differential factor (only the experimental group imitated). We evaluated self-paced movement features and cortico-spinal excitability (recruitment curves and silent periods in both hemispheres) before, immediately after, and two weeks after the training period.
  
  
  
  Movement amplitude increased significantly after the therapy in the experimental group for the trained and un-trained hands. Motor thresholds and silent periods evaluated with transcranial magnetic stimulation were differently modified by training in the two groups; although the changes in the input-output recruitment were similar.
  
  
  
  This pilot study suggests that movement imitation therapy enhances the effect of motor practice in patients with Parkinson's disease; imitation-training might be helpful for reducing hypometria in these patients. These results must be clarified in future larger trials.
authors.affiliation: Neuroscience and Motor Control Group (NEUROcom), Faculty of Health Sciences, INEF-Galicia, and Faculty of Physiotherapy; Universidade da Coruña (Spain) and Institute of Biomedical Research of A Coruña, Spain.
authors.forename: Verónica
authors.initials: V
authors.lastname: Robles-García
authors.affiliation: Neuroscience and Motor Control Group (NEUROcom), Faculty of Health Sciences, INEF-Galicia, and Faculty of Physiotherapy; Universidade da Coruña (Spain) and Institute of Biomedical Research of A Coruña, Spain.
authors.forename: Yoanna
authors.initials: Y
authors.lastname: Corral-Bergantiños
authors.affiliation: Neuroscience and Motor Control Group (NEUROcom), Faculty of Health Sciences, INEF-Galicia, and Faculty of Physiotherapy; Universidade da Coruña (Spain) and Institute of Biomedical Research of A Coruña, Spain.
authors.forename: Nelson
authors.initials: N
authors.lastname: Espinosa
authors.affiliation: Movement Disorders Unit, University of A Coruña Hospital, A Coruña, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: García-Sancho
authors.affiliation: Instituto de Investigaciones Tecnológicas, University of Santiago de Compostela, Spain.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Sanmartín
authors.affiliation: Instituto de Investigaciones Tecnológicas, University of Santiago de Compostela, Spain.
authors.forename: Julián
authors.initials: J
authors.lastname: Flores
authors.affiliation: Neuroscience and Motor Control Group (NEUROcom), Faculty of Health Sciences, INEF-Galicia, and Faculty of Physiotherapy; Universidade da Coruña (Spain) and Institute of Biomedical Research of A Coruña, Spain; Centro de Estimulación Cerebral de Galicia, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Cudeiro
authors.affiliation: Neuroscience and Motor Control Group (NEUROcom), Faculty of Health Sciences, INEF-Galicia, and Faculty of Physiotherapy; Universidade da Coruña (Spain) and Institute of Biomedical Research of A Coruña, Spain. Electronic address: pabloarias.neurocom@udc.es.
authors.forename: Pablo
authors.initials: P
authors.lastname: Arias
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007100:Imitative Behavior / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology; D010300:Parkinson Disease / Q000175:diagnosis* / Q000628:therapy*; D010865:Pilot Projects; D050781:Transcranial Magnetic Stimulation / Q000379:methods; D016896:Treatment Outcome; D063367:Virtual Reality Exposure Therapy / Q000379:methods*
keywords: Hypokinesia; Imitative behaviour; Learning; Parkinson's disease; Transcranial magnetic stimulation; Virtual reality therapy