The feasibility of a self-regulation and mental imagery program to enhance everyday functioning in people with Parkinson’s Disease

Self-regulation and mental imagery for Parkinson's disease (SReMi-PD) program The SReMI-PD program is developed based on a review of theory and scientific evidence on people with stroke as well as two consumer co-design workshops. The strategies are proposed to assist people with Parkinson's disease in focusing attention on task requirements. Previous studies reviewed the benefits of using self-regulation and mental imagery in promoting relearning and generalisation of skills learnt for people with stroke. The SReMI-PD program is run once a week for six weeks with a home program and a phone call by the facilitators to supplement for a second weekly session. The facilitators include an occupational therapist and an occupational therapy honours student. The weekly 45-minute sessions are run face-to-face with between 2-4 members per group. The program is modified for each group’s specific needs by focusing on the activities of daily living with which the specific group may be having difficulty. The program begins with two weeks of learning and applying self-regulation through a step-based problem-solving process designed by the researchers. This includes choosing a task, breaking it down into steps, identifying steps that are problematic or difficult, identifying what the specific problems they are experiencing and brainstorming solutions. Throughout the program, appropriate rehabilitation strategies are suggested and used as solutions to build the participants' knowledge of possible solutions. They include modifying the ‘Task’ and ‘Environment’ and getting ‘Assistance’ (‘TEA’). The acronym ‘TEA’ for ‘Task, Environment, Assistance’ is taught to assist participants with coming up with solutions. External cueing is introduced to the participants as a potential solution. Participants are given the opportunity to try them during the session and then encouraged to implement the solutions at home. The third and fourth sessions introduce mental imagery into the self-regulation process as a method of practicing the task as well as assisting participants to plan their movements. The final two sessions consolidate the use of self-regulation and mental imagery with various everyday tasks while considering current difficulties and potential future difficulties. The home program includes the activities practiced during the face-to-face session that week. It aims at encouraging participants to implement the strategies and solutions at home. To monitor the adherence to the home program, a telephone phone call will be given to the participants to check on any issues or extra support required.