Motor imagery does not effectively improve walking-related performance in older adults: A randomised controlled trial.

Background: Inaccurate perception of one's physical abilities is potentially related to age-related declines in motor planning and can lead to changes in walking. Motor imagery training is effective at improving balance and walking in older adults, but most research has been conducted on older adults following surgery or in those with a history of falls. Deficits in motor imagery ability are associated with reduced executive function in older adults with cognitive impairment.

Objectives: To determine whether walking-specific motor imagery training could improve walking performance (physical and imagined) in healthy older adults, and identify the relationship between actual and imagined movement, motor imagery accuracy and executive function across 5 different walking tasks in healthy older adults.

Methods: A cohort of 53 community dwelling older adults took part in a 4-wk randomized controlled trial to assess the effect of motor imagery training on the physical and imagined performance of 5 walking-related tasks (3 narrow path walking tasks, Timed-up and go and step-over test), together with motor imagery clarity using the kinesthetic and visual imagery questionnaire (KVIQ-10). The association between physical performance, motor imagery accuracy and executive function were identified at baseline.

Results: Four weeks of motor imagery training did not improve walking-specific performance (imagined or physical) compared to no-training. Motor imagery training did improve the visual clarity of imagined non-walking tasks. Executive function was significantly correlated with 2 out of 5 imagined walking tasks and 4 out of 5 physical walking tasks but was not associated with motor imagery accuracy.

Conclusion: Four weeks of motor imagery training is not effective at improving performance in walking-related tasks in healthy older adults. This lack of improvement may be due in part to the high functional ability of the cohort. Future research should assess the relationship between motor planning and executive function with more complex walking tasks.

Trial Registration: ANZCTR registration (ACTRN12619001784101).