MOTOR IMAGERY IN THE CONTEXT OF PELVIC FLOOR DISORDERS
LARS JÄGER *
Faculty of Health and Social Sciences, Hochschule Fresenius, Düsseldorf, Germany and Faculty of Health and Social Sciences, Hochschule Fresenius, Cologne, Germany and ProPhysio, Cologne, Germany
BIRGIT SCHULTE-FREI
ProPhysio, Cologne, Germany and Faculty of Health and Social Sciences, Hochschule Fresenius, Germany
*Author to whom correspondence should be addressed.
Abstract
UI is a widespread symptom affecting Quality of Life (QoL) and causing enormous costs. The only proven conservative therapy is training of the pelvic floor muscles. The effect of the training performed, in turn is strongly dependent on activation of the right muscle synergies. However, muscle activation in this area is hard to control subjectively and involves biofeedback equipment or digital examination for objective validation.
Since Motor Imagery (MI) on the other hand establishes specifically targeted neuronal excitation, MI may constitute an adjunct treatment opportunity to ensure adequate muscular activation.
MI, i.e. the training of sequences of muscle activation by a mental, figurative concept of movement without actual physical movement, has long been used in athletes training for highly accurate, fast or hazardous movements. Since approximately two decades MI is applied in therapeutic settings of various pathologies (e.g. Stroke, Morbus Parkinson and Complex Regional Pain Syndrome).
There is accumulating evidence from athletes and patients that MI leads to various qualitative enhancements. These findings correlate with data from MRI studies, describing structural processes on a neuroactivational/ neuroanatomical basis induced by MI.
As we are currently conducting the first survey implementing MI in patients suffering from UI, the article at hand is designed to describe effects of MI in other target groups, similarities of MI and actual movement as well as neuro-activational and neuroplastic alterations in the context of MI. Lastly, ways of implementing MI in patients suffering from UI is depicted.
Keywords: Motor imagery, mental training, pelvic floor disorders, incontinence, conservative treatment, physical therapy