The use of technology-supported mental imagery in neurological rehabilitation: a research protocol

The human brain can simulate motor actions without physically executing them, and there is a neuro-psychological relationship between imaging and performing a movement. These are shared opinions. In fact there is scientific evidence showing that the mental simulation of an action is correlated to a subliminal activation of the motor system. There is also evidence that virtual stimulation can enhance the acquisition of simple motor sequences. In some situations, virtual training was found to be as beneficial as real training and more beneficial than workbook and no training in teaching complex motor skills to people with learning disabilities. Moreover, studies of brain-injured hemiplegics patients suggest that these patients retain the ability to generate accurate motor images even of actions that they cannot perform. Combined with evidence indicating that motor imagery and motor planning share common neural mechanisms, these observations suggest that supporting mental imagery through non-immersive, low-cost virtual reality (VR) applications may be a potentially effective intervention in the rehabilitation of brain-injured patients. Starting from this background, our goal is to design and develop a new technique for the acquisition of new motor abilities- "imagery enhanced learning" (or I-learning)-to be used in neuro-psychological rehabilitation. A key feature of I-learning is the use of potentially low-cost, Virtual Reality enhanced technology to facilitate motor imagery creating a compelling sense of presence. This paper will discuss the rationale and a preliminary rehabilitation protocol for investigating mental imagery as a means of promoting motor recovery in patients with a neurological disorder. The treatment strategy aims at evoking powerful imaginative responses using an innovative technique which makes no attempt to simulate the real-world motor behavior, but draws the patient's attention to its underlying dynamic structure. This is done by displaying highly stylized sketches of the motor behavior on a computer screen and gradually increasing the perceptual realism of the visualization. This strategy assumes that optimal learning will be achieved when the patient is allowed to elaborate his own schema and sequences of movements, thereby constructing his own personal image of the motor behavior to be trained.