Motor Imagery Training After Stroke: A Systematic Review and Meta-analysis of Randomized Controlled Trials
Journal of Neurologic Physical Therapy: October 2017 - Volume 41 - Issue 4 - p 205–214
doi: 10.1097/NPT.0000000000000200
Systematic Reviews
Background and Purpose: A number of studies have
suggested that imagery training (motor imagery [MI]) has value for
improving motor function in persons with neurologic conditions. We
performed a systematic review and meta-analysis to assess the available
literature related to efficacy of MI in the recovery of individuals
after stroke.
Methods: We searched the following databases:
PubMed, Web of Knowledge, Scopus, Cochrane, and PEDro. Two reviewers
independently selected clinical trials that investigated the effect of
MI on outcomes commonly investigated in studies of stroke recovery.
Quality and risk of bias of each study were assessed.
Results: Of the 1156 articles found, 32 articles
were included. There was a high heterogeneity of protocols among
studies. Most studies showed benefits of MI, albeit with a large
proportion of low-quality studies. The meta-analysis of all studies,
regardless of quality, revealed significant differences on overall
analysis for outcomes related to balance, lower limb/gait, and upper
limb. However, when only high-quality studies were included, no
significant difference was found. On subgroup analyses, MI was
associated with balance gains on the Functional Reach Test and improved
performance on the Timed Up and Go, gait speed, Action Research Arm
Test, and the Fugl-Meyer Upper Limb subscale.
Discussion and Conclusions: Our review reported a
high heterogeneity in methodological quality of the studies and
conflicting results. More high-quality studies and greater
standardization of interventions are needed to determine the value of MI
for persons with stroke.
Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A188).
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