Primes are contextually or spatially relevant stimuli that, through experience, are associated with expected behavior. External and contextually relevant primes have been theorized to guide internally the cognitive functions necessary for ADL and IADL performances (Gage and Storey 2004; Praamstra et al. 1998). Neurologic and motor control research has shown that the brain goes through cognitive programming or ideation before making any action or movement. Priming of this cognitive programming is possible through external priming via semantically related language (Gentilucci et al. 2000; Gentilucci and Volta 2008; Maitra and Telage 2004; Maitra et al. 2003; Maitra and Dasgupta 2005; Maitra 2007).

For example, participants performed reaching and grasping tasks with a wooden block while they silently read the words near, far, small, and large written on the block. Results of this study showed that the participants reached faster when they reach for a block with the word far written on it compared to reaching for a block with word near written on it. Similarly, the grasping aperture was larger when the participant grasped a block with the word large written on it than when the word small was written on it. The conclusion was that the participants automatically associated the meaning of the word with the planning of the action (Gentilucci et al. 2000).

Studying clients with PD and stroke (Maitra et al. 2006), researchers showed that pre-reading of a word that is semantically related to the expected motor performance, positively influenced the performance. Speed and smoothness of the reaching or grasping task (n = 24) were significantly facilitated when the words REACH or GRASP were pre-read (Grossi et al. 2007). The word-based contextual primes have to be in congruency with the movement performances. For example, a reaching performance is not influenced by an unrelated action word such as RETURN or nonsense word such as GA(Miller et al. 2005).

Pulvermüller et al. (2005) explained the mechanism by which action words can prime and facilitate a motor performance. He proposed that words are represented in the brain by a neuronal network (or cell assemblies). The network is formed by neurons that represent a word’s meaning (sensory perception) as well as the neurons that represent the word’s content (motor action). Thus, for example, visually seeing the word REACH (perception), or saying the word REACH, may stimulate the neural network governing the reach action, a phenomenon which can be investigated by functional magnetic resonance imaging (fMRI) data of the brain. For example, when the subjects read the words lick, pick, and kick, the brain showed activation in the sensory association areas of the mouth (for lick), hand (for pick), and leg (for kick) for interpretation of the meaning of the word. The fMRI also showed ­simultaneous activation of the motor areas of the mouth, hand, and leg responsible for licking, picking, and kicking actions (Pulvermüller et al. 2005). These studies provide a strong rationale for the present protocol.

RehabSelfPrime-Speech intervention technique with semantically related action words to action is a simple but evidence-based interventions that can be implemented and incorporated into a regular neuromuscular intervention plan. Additionally, these interventions can be implemented and practiced in multiple settings, including home. There is evidence that adherence to a program is greater when implemented in the home (Ashworth et al. 2005). Because PD is a progressive degenerative disease, it is unrealistic to expect that therapeutic interventions can be sustained over long periods of time. The priming method can be continued by the patient; empowering them to self-manage their symptoms as much as possible (Allen et al. 2012).

The evidence for the RehabSelfPrime-Speech intervention is supported by studies with people suffering from stroke (Maitra et al. 2006) or PD (Maitra 2007), and several empirical studies with older adults provided sufficient rationale to use the protocol in practice (Grossi et al. 2007; Maitra and Telage 2004; Maitra et al. 2003).