The Acute Effects of Motor Imagery Combined With Action Observation Breathing Exercise on Cardiorespiratory Responses, Brain Activity, and Cognition: A Randomized, Controlled Trial

Abstract

Breath and brain activity have been integral to daily life since time immemorial. Cognition and cardiorespiratory responses are closely interlinked, necessitating further investigation into their dynamics. The potential benefits of combining motor imagery (MI) and action observation (AO) based breathing exercises in rehabilitation have not been fully explored. This study was aimed at assessing the acute effects of MI combined with AO on cognitive function and cardiorespiratory responses. Thirty-three healthy adults were randomized into MI combined with AO breathing (MI+AO), active respiratory exercise (ARE), and control groups, with equal distribution across groups. Electroencephalography (EEG) data were collected using a Muse EEG headband, and cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) while imagining activities were measured via the Kinesthetic and Visual Imagery Questionnaire (KVIQ). Significant improvements in the Timed Up and Go (TUG) test and systolic blood pressure were observed in the ARE group (p < 0.05), alongside improvements in MoCA and KVIQ scores (p < 0.05). EEG data revealed significant decreases in delta and theta power at the temporoparietal (TP) location in the ARE group (p < 0.05). These findings suggest that MI and AO, when combined with respiratory exercises, may serve as effective passive strategies to support cognition and cardiorespiratory function, particularly in individuals who struggle to actively participate in pulmonary rehabilitation.

Trial Registration: ClinicalTrials.gov identifier: NCT06099483