Autonomic Nervous System Clinical Trial
Official title:
Combining Motor Imagery With Action Observation Does Not Lead to a Greater Autonomic Response Than Motor Imagery Alone During Simple and Functional Movements: a Randomized Controlled Trial.
The main objective of this study was to compare the activation of the Sympathetic Nervous System in a program that combined Motor Imagery with Action Observation, in contrast to an isolated Motor Imagery program on the one hand in asymptomatic subjects and in the other hand in patients with chronic low back pain.
Motor Imagery (MI) is defined as a dynamic mental process that involves the representation of
an action, in an internal way, without its actual motor execution. The Action Observation
(AO) evokes an internal, real-time motor simulation of the movements that the observer is
perceiving visually. Both mental processes trigger the activation of the neurocognitive
mechanisms that underlie the planning and execution of voluntary movements in a manner that
resembles how the action is performed in a real manner.
Both observation and imagination share a great number of common mental processes based
primarily on sensory perception, and the information stored by memory systems. The activation
of the motor command during a mental practice does not induce an active movement probably due
to an inhibitory mechanism in the primary motor cortex on the descending corticospinal tract
pathways. However, this inhibition is not complete, for it is well known that the training of
mental practice involves a component of the autonomic nervous system (ANS).
It has been shown that both MI and AO lead to changes in the ANS that cause excitatory
sympathetic responses, although the neurophysiological bases remain uncertain and are still
based on hypotheses. The functional relations between both neurocognitive processes and the
sympathetic-excitatory nervous system (SNS) could be based on a preparation phase in which,
the activation of the SNS, happens to a near effort and, therefore, to a close energy
expenditure in physiological processes (i.e., cardiorespiratory adaptationse) which will take
place in order to face said metabolic changes produced by the voluntary movement itself. In
addition, several hypotheses have been described regarding the notion that the SNS not only
has the quantitative objective of providing energy to the muscle effectors, but that it also
qualitatively and specifically designs and adapts the parameters on demand in an attempt to
save the energy provided for each precise motor execution.
Taking into account that both MI and AO cause sympathetic-excitatory changes that induce an
increase in heart rate, blood pressure, respiratory rate, electrodermal activity , our
hypothesis is that the combination of MI and AO induces an autonomic sympathetic-excitatory
shift greater than MI does in isolation. Therefore, the main objective of this study was to
compare the results obtained from intervention groups on the subject of the activation of the
SNS in a program that combined MI with AO, in contrast to an isolated MI program on the one
hand in asymptomatic subjects and in the other hand in patients with chronic low back pain..
The secondary objective of the present study was to explore whether there is any relationship
between the sympathetic-excitatory response and the ability to generate motor imagery, the
mental chronometry, and the level of physical activity.
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