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Parkinson's (15)

27 Aug

We’ve gotten half a dozen questions like this one in the last week alone, so we figured we’d best post this question and answer this question from a program manager of a Kingston, Ontario agency that provides community-based services to adults with brain injury:


Dear Belleruth,

Thank you for your efforts with producing a guided imagery for TBI.  I am a Program Manager in Kingston, Ontario, providing community-based services to adults affected by brain injury. I have been an admirer of your work for many years and have been pleased with your more recent focus on brain injury.
You may remember I had hoped to have you come to Kingston for a conference on TBI, particularly from military service. Unfortunately, the government funding did not come through and we had to cancel your engagement. I still hope this can happen some day.

My question to you is about the TBI guided imagery. Do you think it would also be helpful to people with acquired brain injury? Our referral base is about 50% TBI and 50% ABI with the causes of ABI being infection, tumours, and stroke (with diffuse effects).

Thank you,


27 Aug

Researchers from the Oxford Brookes University in the United Kingdom investigated the feasibility of integrating a motor imagery program into a treatment regimen of physiotherapy and occupational therapy for patients diagnosed with stroke, brain injury or multiple sclerosis.

Thirty inpatients and outpatients in treatment at a neurologic rehabilitation center participated in the study. A parallel-group, phase II, assessor-blind randomized controlled trial compared motor imagery embedded in treatment as usual with treatment as usual only. Subjects were assessed at baseline, after 6 weeks (post-intervention), and after 12 weeks (follow-up).

A motor imagery strategy was developed and integrated into treatment as usual (physiotherapy and occupational therapy) which was tailored to individual goals, and applied to any activity. The control group received standard care (physiotherapy and occupational therapy).

05 Mar


Dear BR,

I read your newsletters religiously and offer guided imagery in my practice as a Yoga Therapist.  With a specialty in Parkinson's Disease and neurological disorders, I always refer your products to my students and clients.

When I engage in a guided imagery  practice with my clients, leaving the setting and details to them, rather than make suggestions, they sometimes retreat to situations from the past that are no longer possible for them, such as playing golf, running or hiking alone.

I often wonder if this does not set the stage for more grief and possibly denial, and would like your thoughts on leaving them to their own images, or gently guiding them toward one that does not have potential for angst.
Thank you for all you do.


23 Jan

Because guided motor imagery has recently gained so much attention as a promising new rehabilitation method for patients with neurological disorders, researchers from Katholieke Universiteit in Leuven, Belgium, tested whether patients with Parkinson’s Disease had the capacity for doing imagery, in spite of impaired basal ganglia function.

A total of 14 patients with early- and mid-stage PD (Hoehn and Yahr 1-3) and 14 healthy controls were evaluated by means of an extensive imagery ability assessment battery, consisting of 2 questionnaires, the Chaotic Motor Imagery Assessment battery, and a test based on mental chronometry.

12 Apr

Dear Belleruth,

My wife was diagnosed with PD 14 years ago.  For a long while before that we thought she was depressed.  Now we know it was probably the beginnings of the Parkinsons.  Our kids don’t live in town.  I am her main care partner and do what I can to encourage and support her.  I bring her to support group meetings when she’s willing to go.  Sometimes I go without her anyway, because it helps me either way.

I’m extremely frustrated at the way she resists suggestions for help.  I’ve brought home books, nutritional supplements, suggestions for physical therapy, chair yoga videos and, yes, even your guided imagery for PD.  She mostly acts like a rebellious teenager or a passive resister.  This has caused tension in the home and a lot of anger inside me.

I just don’t understand her attitude.  When I had open heart surgery years ago, I fought hard to get well again, in spite of pain, weakness and depression.  I tried all kinds of life style changes, many of which I still do today.  I know this sounds foolish, but what can I do? Why can’t she be more like me? 

John (who loves but wants to strangle his wife)

04 Oct

Researchers from the Department of Neurology at Rambam Hospital in Haifa, Israel examined whether a Parkinson’s Disease (PD) tremor, known to worsen with stress, could improve with what they refer to as “relaxation guided imagery” (RGI) and calming music.

Twenty PD patients with moderate to severe tremor participated in sessions where relaxation techniques were implemented. Tremor was objectively monitored using an accelerometer.

All 20 subjects in the imagery condition (RGI) had dramatically decreased  tremor (baseline 270.38 +/- 85.82 vs. RGI 35.57 +/- 43.90 movements per minute P < 0.0001).  Additionally, in 15 patients, the tremor was completely gone for 1-13 min.

12 Apr

We got this email recently: 
I want to praise Carol Dickman’s Seated Yoga video and Belleruth’s Parkinson’s Disease imagery.  My husband who has been disabled and depressed with his illness for several years responds well to these.  He works with both each day.  He is less depressed, sleeps better and we both think he has gotten somewhat better at getting himself to move when he is “stalled”, which is what we call it when there is a gap between when he wants to use his muscles and when they respond.

28 Mar

Guided Motor Imagery Helps with Athletic Performance, Neurological Conditions

Investigators at the University of Haifa in Israel reviewed the literature to determine the positive effects of guided motor imagery practice on motor performance. There is abundant evidence that motor performance is improved in athletes, people who are healthy, and people with neurological conditions, such as stroke, spinal cord injury and Parkinson’s disease. This article discusses how to integrate motor imagery into a physical therapy practice and goes into particulars of visual and kinesthetic motor imagery, factors that modify motor imagery practice, the design of motor imagery protocols, and potential applications of motor imagery.

Citation: Dickstein R, Deutsch JE. Motor imagery in physical therapist practice. Physical Therapy. 2007 Jul; 87 (7): pages 942-53. Epub 2007 May 1 This email address is being protected from spambots. You need JavaScript enabled to view it.

11 May

Researchers from the Department of Rehabilitation Medicine at the Bronx V.A. Medical Center, in a double-blind, randomized, pilot study, examined the effects of acupuncture on PD-associated symptoms. No significant changes were found.

Researchers from the Department of Rehabilitation Medicine at the Bronx V.A. Medical Center performed a double-blind, randomized, pilot study to determine the effects of acupuncture upon a variety of PD-associated symptoms, as compared to a control condition.

Fourteen patients with Stage II or III PD received acupuncture or a control non-acupuncture protocol. Before and after treatment, patients were evaluated using the Motor subscale of the Unified Parkinson''s Disease Rating Scale (UPDRS), the Parkinson''s Disease Questionnaire (PDQ-39), and the Geriatric Depression Scale.

There were no statistically significant changes for the outcomes measured. In the patients who received acupuncture, nonsignificant trends toward improvement were noted in the Activities of Daily Living score of the PDQ-39 and the PDQ-39 Summary.

Citation: Cristian A, Katz M, Cutrone E, Walker RH. Evaluation of acupuncture in the treatment of Parkinson''s disease: a double-blind pilot study. Movement Disorders. 2005 Sep; 20 (9): pages 1185-8.

04 May

Researchers at the University of Kansas Medical Center in Kansas City find that tui na massage, acupuncture, and qigong improved subjective quality of life & reduced depression, but UPDRS motor scores actually worsened..

Researchers at the University of Kansas Medical Center in Kansas City evaluated the effects of sequential tui na massage, acupuncture, and instrument-delivered qigong for patients with Parkinson disease (PD) over a 6-month period. Twenty-five patients received weekly treatments, which included tui na massage prior to acupuncture followed by instrument-delivered qigong. Each patient was assessed at baseline and at 6 months.

Before and after treatment patients were evaluated with the Unified Parkinson Disease Rating Scale (UPDRS), Hoehn and Yahr Staging (H&Y), Schwab and England Activities of Daily Living (S & E), Beck Depression Inventory (BDI), Parkinson''s Disease Questionnaire (PDQ-39) quality of life assessment, and patient global assessments.