Investigation of the Effect of Combined Motor Imagery and Activity Observation Therapy on Strengthening the Non-Dominant Hand in Healthy Individuals

Summary

Introduction:

Motor Imagery (MI) and Action Observation (AO) are well-established cognitive training techniques that activate neural networks similar to those involved in actual motor execution. MI involves the mental rehearsal of a movement without physically performing it, while AO relies on observing an action performed by others to stimulate motor-related brain areas. Recent studies suggest that when these methods are combined, they may enhance motor learning, cortical plasticity, and strength gains more effectively than when applied alone. The non-dominant hand, often less trained and weaker in performance compared to the dominant hand, provides an ideal model to examine the effects of these interventions. Strengthening the non-dominant upper limb has implications not only for improving functional balance between the limbs in healthy individuals but also for potential clinical applications in rehabilitation.

Aim:

The primary aim of this randomized controlled study is to investigate the combined effect of MI and AO on muscular strength and functional performance of the non-dominant hand in healthy university students. Specifically, the study seeks to compare the outcomes of three groups: (1) AO combined with MI, (2) MI only, and (3) a control group with no intervention. It is hypothesized that participants in the AO+MI group will demonstrate greater improvements in grip strength and functional outcomes compared to the other groups.

Evaluation:

To comprehensively measure the effects of the intervention, several standardized assessment tools will be employed. Motor imagery ability will be evaluated using the Motor Imagery Questionnaire-3 (MIQ-3). Hand dominance will be determined by the Edinburgh Handedness Inventory. Grip strength will be objectively measured using a Hand Grip Dynamometer. The Recognise App will be used to assess laterality recognition and sensorimotor integration, while overall upper limb function will be measured through the Short Musculoskeletal Function Assessment (SMMT). These evaluations will be conducted both before and after the 4-week intervention period to track changes.

Treatment:

The intervention will span four weeks, with participants attending 2-3 sessions per week. Training protocols will include both cognitive and physical components. In the MI group, participants will engage in guided motor imagery sessions focused on visualizing non-dominant hand exercises. The AO+MI group will observe video demonstrations of the same hand movements, followed by simultaneous motor imagery practice, thereby combining visual and cognitive engagement. Physical strengthening exercises will include dumbbell wrist flexion and handball squeeze, targeting key muscles of the non-dominant hand and forearm. The control group will not undergo any intervention during this period. By integrating AO and MI with specific strengthening exercises, the study aims to determine whether this combined approach enhances neural activation and muscular strength more effectively than MI alone.

Conditions

• Hand

Interventions

OTHER

Conservative treatment + Motor imagery program

Participants will perform guided motor imagery of non-dominant hand strengthening exercises (dumbbell wrist flexion and handball squeeze) without video observation, 5 sessions per week for 4 weeks.

OTHER

Conservative treatment + Motor imagery and action observation program

Participants will observe videos of non-dominant hand strengthening exercises (dumbbell wrist flexion and handball squeeze) and simultaneously perform guided motor imagery of the same movements, 5 sessions per week for 4 weeks.

OTHER

Conservative treatment via strengthening exercises

Participants will perform only the physical strengthening exercises (dumbbell wrist flexion and handball squeeze) for the non-dominant hand, 5 sessions per week for 4 weeks, without any motor imagery or action observation.

Sponsors & Collaborators

• Bahçeşehir University

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

65 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2025-11-20

Primary Completion

2026-01-16

Completion

2026-01-16

Countries

• Turkey (Türkiye)

Study Locations