Abstract
Background
Stroke is the second leading cause of death and a leading cause of disability worldwide.
Motor imagery is a technique that can be utilized in the rehabilitation process to
improve the lives of patients with a functional disability acquired by this pathology.
Aim
To evaluate the effects of motor imagery as a complementary intervention for the rehabilitation
of stroke patients.
Methods
We conducted a systematic review in MEDLINE/PubMed, Scopus, Web of Science, and PEDro
databases. We included randomized controlled trials (RCTs) that used motor imagery
as a complementary resource for the rehabilitation of patients affected by stroke,
who had motor function and functional independence as outcomes.
Results
Of the 1,473 studies found, ten RCTs were included. Regarding the interventions, motor
imagery was associated with traditional rehabilitation, virtual reality, physical
practice, structured progressive circuit class therapy, and electromyography. The
upper and lower extremity performance were accessed through the Fugl-Meyer Assessment
(FMA) and gait speed, respectively. Although the practice of motor imagery at least
twice a week during three weeks showed to be effective in improving the motor performance
of post-stroke patients, the studies’ protocols present a high heterogeneity, with
training session times lasting between 30 to 180 minutes and a post-stroke invention
window of one to 12 months.
Conclusions
Motor imagery has been shown to be an efficacious technique in the treatment of post-stroke
patients when used as a complement to traditional rehabilitation techniques. However,
greater standardization of interventions and studies with higher methodological quality
are required to determine further conclusions.
Key Words
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References
- Pragmatic trial of multifaceted intervention (STROKE-CARD care) to reduce cardiovascular risk and improve quality-of-life after ischaemic stroke and transient ischaemic attack – study protocol.BMC Neurol. 2018; 18: 187https://doi.org/10.1186/s12883-018-1185-2
- Atrial high-rate episodes and stroke prevention.Europace. 2019; 19: 169-179https://doi.org/10.1093/europace/euw279
- Utilization of physiotherapy in the continuum of stroke care at a tertiary hospital in Ibadan, Nigeria.Afr Health Sci. 2017; 17: 79-87https://doi.org/10.4314/ahs.v17i1.11
- Predicting long-term cardiovascular events after transient ischemic attacks: Carotid artery intima-media thickness or ABCD2 score or both?.Int J Prev Med. 2018; 9: 102https://doi.org/10.4103/ijpvm.IJPVM_415_17
- Canadian stroke best practice recommendations: secondary prevention of stroke, sixth edition practice guidelines, update 2017.Int J Stroke. 2017; 13: 420-443https://doi.org/10.1177/1747493017743062
- Motor strategies of postural control after hemispheric stroke.Neurophysiol Clin. 2015; 45 (10.1016j.neucli.2015.09.003): 327-333
- Post-stroke movement disorders: The clinical, neuroanatomic, and demographic portrait of 284 published cases.J Stroke Cerebrovasc Dis. 2018; 27: 2388-2397https://doi.org/10.1016/j.jstrokecerebrovasdis.2018.04.028
- Guidelines for adult stroke rehabilitation and recovery: A guideline for healthcare professionals from the American Heart Association/American Stroke Association.Stroke. 2016; 47: e98-e169https://doi.org/10.1161/STR.0000000000000098
- Strength of the lower limb and trunk muscles is associated with gait speed in individuals with sub-acute stroke: a cross-sectional study.Braz J Phys Ther. 2018; 22: 459-466https://doi.org/10.1016/j.bjpt.2018.03.001
- Canadian stroke best practice recommendations: secondary prevention of stroke, sixth edition practice guidelines, update 2017.Int J Stroke. 2017; 13: 420-443https://doi.org/10.1177/1747493017743062
- Functional brain connectivity during multiple motor imagery tasks in spinal cord injury.Neural Plast. 2018; 20189354207https://doi.org/10.1155/2018/9354207
- Motor-imagery ability and function of hemiplegic upper limb in stroke patients.Ann Clin Transl Neurol. 2019; 6: 596-604https://doi.org/10.1002/acn3.739
- Effects of motor imagery on walking function and balance in patients after stroke: A quantitative synthesis of randomized controlled trials.Complement Ther Clin Pract. 2017; 28: 75-84https://doi.org/10.1016/j.ctcp.2017.05.009
- Finding the intersection of neuroplasticity, stroke recovery, and learning: scope and contributions to stroke rehabilitation.Neural Plast. 2019; 20195232374https://doi.org/10.1155/2019/5232374
- Long-term memory and the analysis of its function on the learning process.Rev Ens Educ Cienc Human. 2018; 19: 66-72https://doi.org/10.17921/2447-8733.2018v19n1p66-72
- Neural plasticity during motor learning with motor imagery practice: review and perspectives.Neuroscience. 2017; 341: 61-78https://doi.org/10.1016/j.neuroscience.2016.11.023
- What do eye gaze metrics tell us about motor imagery?.PLoS One. 2015; 10e0143831https://doi.org/10.1371/journal.pone.0143831
- Cortical changes after mental imagery training combined with electromyography-triggered electrical stimulation in patients with chronic stroke.Stroke. 2012; 43: 2506-2509https://doi.org/10.1161/STROKEAHA.112.663641
- Motor imagery in physical therapist practice.Phys Ther. 2007; 87: 942-953https://doi.org/10.2522/ptj.20060331
- Cognitive motor processes: the role of motor imagery in the study of motor representations.Brain Res Rev. 2009; 60: 306-326https://doi.org/10.1016/j.brainresrev.2008.12.024
- Phantom limb pain, cortical reorganization and the therapeutic effect of mental imagery.Brain. 2008; 131: 2181-2191https://doi.org/10.1093/brain/awn124
- Influence of motor imagery training on gait rehabilitation in sub-acute stroke: a randomized controlled trial.J Rehabil Med. 2015; 47: 204-209https://doi.org/10.2340/16501977-1908
- Motor imagery as a complementary technique for functional recovery after stroke: a systematic review.Top Stroke Rehabil. 2019; 26: 576-587https://doi.org/10.1080/10749357.2019.1640000
- The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration.BMJ. 2009; 339: b2700https://doi.org/10.1136/bmj.b2700
- Motor imagery training after stroke: a systematic review and meta-analysis of randomized controlled trials.J Neurol Phys Ther. 2017; 41: 205-214https://doi.org/10.1097/NPT.0000000000000200
- Assessing quality of reports of randomized clinical trials: is blinding necessary?.Control Clin Trials. 1996; 17: 1-12https://doi.org/10.1016/0197-2456(95)00134-4
- Avaliação do risco de viés de ensaios clínicos randomizados pela ferramenta da colaboração Cochrane.Diagn Tratamento. 2013; 18: 38-44
- GRADE guidelines: 5. Rating the quality of evidence–publication bias.J Clin Epidemiol. 2011; 64: 1277-1282https://doi.org/10.1016/j.jclinepi.2011.01.011
- Effects of mental practice combined with electromyogram-triggered electrical stimulation for upper extremity function in stroke patients.J Phys Ther Sci. 2017; 29: 1819-1820https://doi.org/10.1589/jpts.27.3499
- Effects of virtual reality and motor imagery techniques using Fugl Meyer Assessment scale in poststroke patients.Int J Ther Rehabil. 2018; 25: 587-595https://doi.org/10.12968/ijtr.2018.25.11.587
- A randomized controlled trial of motor imagery combined with structured progressive circuit class therapy on gait in stroke survivors.Sci Rep. 2020; 10: 6945https://doi.org/10.1038/s41598-020-63914-8
- Motor imagery training on muscle strength and gait performance in ambulant stroke subjects-A randomized clinical trial.J Clin Diagnostic Res. 2016; 10: YC01-YC04https://doi.org/10.7860/JCDR/2016/16254.7358
- Effects of adjuvant mental practice using inverse video of the unaffected upper limb in subacute stroke: a pilot randomized controlled study.Int J Rehabil Res. 2019; 42: 337-343https://doi.org/10.1097/MRR.0000000000000368
- Retention of the spacing effect with mental practice in hemiparetic stroke.Exp Brain Res. 2016; 234: 2841-2847https://doi.org/10.1007/s00221-016-4686-5
- The effects of game-based virtual reality movement therapy plus mental practice on upper extremity function in chronic stroke patients with hemiparesis: a randomized controlled trial.J Phys Ther Sci. 2016; 28: 811-815https://doi.org/10.1589/jpts.28.811
- Effect of motor imagery training in combination with electromyographytriggered electrical stimulation in stroke with hemiplegia patients: a randomized controlled study.J Theor Biol. 2019; 191940062https://doi.org/10.1142/S0219519419400621
- Improving motor imagery practice with synchronous action observation in stroke patients.Top Stroke Rehabil. 2016; 23: 245-253https://doi.org/10.1080/10749357.2016.1141472
- The reorganization of resting-state brain networks associated with motor imagery training in chronic stroke patients.IEEE Trans Neural Syst Rehabilitation Eng. 2019; 27: 2237-2245https://doi.org/10.1109/TNSRE.2019.2940980
- Effect of sling exercise training on balance in patients with stroke: a meta-analysis.PLoS One. 2016; 11e0163351https://doi.org/10.1371/journal.pone.0163351
- Rehabilitation that incorporates virtual reality is more effective than standard rehabilitation for improving walking speed, balance and mobility after stroke: a systematic review.J Physiother. 2015; 61: 117-124https://doi.org/10.1016/j.jphys.2015.05.017
- Randomized trial of treadmill training to improve walking in community-dwelling people after stroke: The AMBULATE trial.Int J Stroke. 2013; 8: 436-444
- A preliminary study of dual-task training using virtual reality: influence on walking and balance in chronic poststroke survivors.J Stroke Cerebrovasc Dis. 2019; 28104343https://doi.org/10.1016/j.jstrokecerebrovasdis.2019.104343
Article Info
Publication History
Published online: May 26, 2021
Accepted:
May 1,
2021
Received in revised form:
April 8,
2021
Received:
October 2,
2020
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2021.105876
Copyright
© 2021 Elsevier Inc. All rights reserved.
