ClinicSpeak: physical rehabilitation using your imagination

Never underestimate the power of imagination. #MSResearch #MSBlog #ClinicSpeak

“My brother-in-law who is a petrol head was a major Ayrton Senna fan and had the opportunity of meeting him. He told me that one of the reasons why Senna was so good is that he used motor imagery to practice; in addition to practising out on the track he used to spend hours, and hours, imaging racing on a particular track. He would mentally go through the gear changes, imagining the accelerations, decelerations and driving on and off the racing line. He told my brother-in-law that for every physical lap he practice he would 10 or more imaginary laps and he would vary the laps in his thoughts. He would even practice different overtaking manoeuvres in his mind. He claimed the mental imagery was what gave him the edge. I am, therefore, not surprised that cued motor imagery in relation to walking helps improve walking speed, fatigue and quality of life in MSers. I am not saying this can replace physical exercise, but it can augment it and all you need is a pair of headphones, music and an imagination. Easier said than done?”

Seebacher et al.  The effect of rhythmic-cued motor imagery on walking, fatigue and quality of life in people withmultiple sclerosis: A randomised controlled trial.Mult Scler. 2016 Apr 7. pii: 1352458516644058. [Epub]

BACKGROUND: Motor imagery and rhythmic auditory stimulation are physiotherapy strategies for walking rehabilitation.

OBJECTIVES: To investigate the effect of motor imagery combined with rhythmic cueing on walking, fatigue and quality of life (QoL) in people with multiple sclerosis (MS).

METHODS: Individuals with MS and Expanded Disability Status Scale scores of 1.5-4.5 were randomised into one of three groups: 17 minutes of motor imagery, six times per week, for 4 weeks, with music (A) or metronome cues (B), both with verbal cueing, and (C) controls. Primary outcomes were walking speed (Timed 25-Foot Walk) and distance (6-Minute Walk Test). Secondary outcomes were walking perception (Multiple Sclerosis Walking Scale-12), fatigue (Modified Fatigue Impact Scale) and QoL (Short Form-36 Health Survey, Multiple Sclerosis Impact Scale-29, Euroquol-5D-3L Questionnaire).

RESULTS: Of the 112 participants randomised, 101 completed the study. Compared to controls, both interventions significantly improved walking speed, distance and perception. Significant improvements in cognitive but not psychosocial fatigue were seen in the intervention groups, and physical fatigue improved only in the music-based group. Both interventions improved QoL; however, music-cued motor imagery was superior at improving health-related QoL.

CONCLUSIONS: Rhythmic-cued motor imagery improves walking, fatigue and QoL in people with MS, with music-cued motor imagery being more effective.

About the author

Prof G

Professor of Neurology, Barts & The London. MS & Preventive Neurology thinker, blogger, runner, vegetable gardener, husband, father, cook and wine & food lover.


  • Am a software engineer for one of the big banks. My eyes were not working properly together after the first attack. i imagined that I was writing code or software to fix it. I imagined that I was pushing the code down the stack to upgrade my firmware combined with my own eye physio exercises that I created. It fixed the problem, both eyes have been working together for about 9 months now.

    • My fiance' says the exact same thing Aidan!

      He's been coding since the 8080 Intel CPU came along starting with CP/M and assembler.

      He says the brain is a biocomputer complete except its native mode is for the most part multiprocessing and not multitasking. He thinks that the modern society transition in work and carrying over into life of multitasking is an enormous creator of stress on the brain .vs. learning how to better multiprocess. Music Therapy is multiprocessing, read it, play it, sing it, compose it… Brain lights right up in core usage.

      In fact, he believes populations are being trained out of multiprocessing quite intentionally. It is less productive in many ways but affords far more control over masses.

      All that aside he says the same thing. Using imagery and training on it allows for an active thought pattern that can assist and indeed direct many aspects of physiology and even brain processing itself.

      Imagery is quite ancient and thus in modern medicine was discarded for the most part. Now, science is back to reviewing many aspects of natural based healing. It should not be a surprise, our bodies are driven by the brain, the CPU. Its the ultimate pattern matching machine. Even the thought in respect to the lymphatic/immune system are now in question due to research from last year that may rewrite immunology academia.

      Cells are not stupid. They have a program in the DNA.

      That said, while the brain is the computer complete with I/O systems, memory, CPUs (Neural nets ever so complex) what is the programmer?

      Answer: The soul.

      Science tends say, "Nope. Environment, whats taught, etc." Reality is if I tune it out. I decide plug my ears, where a mask, whatall to inhibit stimulus it wont be committed. Thats a choice. The choice comes from the soul.

      I can cite considerably more towards proofing that and would love debate on it. So far, three researchers local between I and my fiance' have turned them towards a MUCH deeper level of thought about all this. Its just not something they considered in broadband and then granular context.

      He has actually rid himself numerous times from the annual flu (three times since I have known him) via similar protocol without meds. twice in a bit under a week.

      I am still trying learn it all. But yes, its like writing a program calling body subsystems and running it over and over and over highly focused on it. Mentally seeing it run and work.

  • Airton Senna was an excellent racing hall, is a idol in Brazil. Is actually he was "mental training": in various interviews it given here in Brazil he told about his routine training and spoke openly about how to imagine situations, the various possible and have outputs, plans they helped him in the races and be victorious.
    "Legend" that even he sensed hours before the fateful race in which he died he had sensed that this wasn't a day of good race, Jr e as very melancholic.
    Finally another athlete who looks much training the mind is Michael Phelps. I read a recent interview with his coach and he said that one of the requirements for Phelps's success beyond the extraordinary ability to swim and unique physical abilities he performs a similar mental training to the Airton Senna did.

    I from the beginning have very trained my mind. Having a spinal cord injury in the cervical that caused me the outbreak that made me discover the MS, I lost strength in his left leg.
    Then I heard a lot of people that I might not be able to recover her movement completely or he would never go back to working out.
    So I started to focus on the left leg lost strength. He focused on it during physical therapy and thought "now I'm feeling you" and started the disease-modifying treatment as soon as possible. When I returned to the gym I started doing exercises looking at the affected leg and thinking that she was there, answering, making an active part of my body. And gradually the leg was regaining strength until approaching normality.

    I don't know, maybe this work early in the disease, aided by the use conjunction some DMT, preferably high-efficiency…

By Prof G



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