Journal of Neuroengineering and Rehabilitation Efficacy of Motor Imagery in Post-stroke Rehabilitation: a Systematic Review

BackgroundEvaluation of how Motor Imagery and conventional therapy (physiotherapy or occupational therapy) compare to conventional therapy only in their effects on clinically relevant outcomes during rehabilitation of persons with stroke.DesignSystematic review of the literatureMethodsWe conducted an electronic database search in seven databases in August 2005 and also hand-searched the bibliographies of studies that we selected for the review.Two reviewers independently screened and selected all randomized controlled trials that compare the effects of conventional therapy plus Motor Imagery to those of only conventional therapy on stroke patients.The outcome measurements were: Fugl-Meyer Stroke Assessment upper extremity score (66 points) and Action Research Arm Test upper extremity score (57 points).Due to the high variability in the outcomes, we could not pool the data statistically.ResultsWe identified four randomized controlled trials from Asia and North America. The quality of the included studies was poor to moderate. Two different Motor imagery techniques were used (three studies used audiotapes and one study had occupational therapists apply the intervention). Two studies found significant effects of Motor Imagery in the Fugl-Meyer Stroke Assessment: Differences between groups amounted to 11.0 (1.0 to 21.0) and 3.2 (-4 to 10.3) respectively and in the Action Research Arm Test 6.1 (-6.2 to 18.4) and 15.8 (0.5 to 31.0) respectively. One study did not find a significant effect in the Fugl-Meyer Stroke Assessment and Color trail Test (p = 0.28) but in the task-related outcomes (p > 0.001).ConclusionCurrent evidence suggests that Motor imagery provides additional benefits to conventional physiotherapy or occupational therapy. However, larger and methodologically sounder studies should be conducted to assess the benefits of Motor imagery.

[1]  E. D. Ryan,et al.  Cognitive demand, imagery, and frequency of mental rehearsal as factors influencing acquisition of motor skills. , 1981 .

[2]  R. Lyle.  A performance test for assessment of upper limb function in physical rehabilitation treatment and research , 1981, International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation.

[3]  D. Landers,et al.  The effects of mental practice on motor skill learning and performance: A meta-analysis. , 1983 .

[4]  D. F. Marks,et al.  Individual differences in mental imagery experience: developmental changes and specialization. , 1994, British journal of psychology.

[5]  Carolyn Copper,et al.  Does mental practice enhance performance , 1994 .

[6]  G. Riet,et al.  Commentary on rampes et al ‘Does electroacupuncture reduce craving for alcohol? A randomized controlled study’ , 1997 .

[7]  R. V. Leeuwen,et al.  Mental practice and imagery: a potential role in stroke rehabilitation , 1998 .

[8]  J. Decety,et al.  Neural mechanisms subserving the perception of human actions , 1999, Trends in Cognitive Sciences.

[9]  M. Jeannerod,et al.  Mental imaging of motor activity in humans , 1999, Current Opinion in Neurobiology.

[10]  S. Page,et al.  Imagery Improves Upper Extremity Motor Function in Chronic Stroke Patients: A Pilot Study , 2000 .

[11]  J B Poline,et al.  Partially overlapping neural networks for real and imagined hand movements. , 2000, Cerebral cortex.

[12]  I-Nan Lien,et al.  Influencing factors and ambulation outcome in patients with dual disabilities of hemiplegia and amputation. , 2000, Archives of physical medicine and rehabilitation.

[13]  S. Page,et al.  A randomized efficacy and feasibility study of imagery in acute stroke , 2001, Clinical rehabilitation.

[14]  C. Richards,et al.  Potential role of mental practice using motor imagery in neurologic rehabilitation. , 2001, Archives of physical medicine and rehabilitation.

[15]  S. Page,et al.  Mental practice combined with physical practice for upper-limb motor deficit in subacute stroke. , 2001, Physical therapy.

[16]  J. H. van der Lee,et al.  The intra- and interrater reliability of the action research arm test: a practical test of upper extremity function in patients with stroke. , 2001, Archives of physical medicine and rehabilitation.

[17]  N. Callow,et al.  Types of Imagery Associated with Sport Confidence in Netball Players of Varying Skill Levels , 2001 .

[18]  S. Black,et al.  The Fugl-Meyer Assessment of Motor Recovery after Stroke: A Critical Review of Its Measurement Properties , 2002, Neurorehabilitation and neural repair.

[19]  N. Byl,et al.  Effectiveness of Sensory and Motor Rehabilitation of the Upper Limb Following the Principles of Neuroplasticity: Patients Stable Poststroke , 2003, Neurorehabilitation and neural repair.

[20]  M. Hallett,et al.  Functional properties of brain areas associated with motor execution and imagery. , 2003, Journal of neurophysiology.

[21]  D. Corbett,et al.  Efficacy of Rehabilitative Experience Declines with Time after Focal Ischemic Brain Injury , 2004, The Journal of Neuroscience.

[22]  H. Vet,et al.  Clinimetric Properties of the Motor Activity Log for the Assessment of Arm Use in Hemiparetic Patients , 2004, Stroke.

[23]  Chetwyn C. H. Chan,et al.  Mental imagery for promoting relearning for people after stroke: a randomized controlled trial. , 2004, Archives of physical medicine and rehabilitation.

[24]  Hermano I Krebs,et al.  Rehabilitation robotics: pilot trial of a spatial extension for MIT-Manus , 2004, Journal of NeuroEngineering and Rehabilitation.

[25]  H. C. Dijkerman,et al.  Does motor imagery training improve hand function in chronic stroke patients? A pilot study , 2004, Clinical rehabilitation.

[26]  R. Dickstein,et al.  Motor imagery for gait rehabilitation in post-stroke hemiparesis. , 2004, Physical therapy.

[27]  C. Hui-Chan,et al.  Mental imagery for relearning of people after brain injury , 2004, Brain injury.

[28]  J. Schaechter.  Motor rehabilitation and brain plasticity after hemiparetic stroke , 2004, Progress in Neurobiology.

[29]  S. McDonough,et al.  The adjunctive role of mental practice in the rehabilitation of the upper limb after hemiplegic stroke: a pilot studya , 2004, Clinical rehabilitation.

[30]  Julien Doyon,et al.  Neurorehabilitation and Neural Repair Stroke: a Case Report the Efficacy of Combined Physical and Mental Practice in the Learning of a Foot-sequence Task after Neurorehabilitation and Neural Repair Additional Services and Information For , 2022 .

[31]  S. Page,et al.  Effects of mental practice on affected limb use and function in chronic stroke. , 2005, Archives of physical medicine and rehabilitation.

[32]  Jeffery J. Summers,et al.  Neural plasticity and bilateral movements: A rehabilitation approach for chronic stroke , 2005, Progress in Neurobiology.

[33]  D. Beevers,et al.  The atlas of heart disease and stroke , 2005, Journal of Human Hypertension.

[34]  George A. Mensah,et al.  The atlas of heart disease and stroke , 2005 .

[35]  D. Wade,et al.  The effects of mental practice in stroke rehabilitation: a systematic review. , 2006, Archives of physical medicine and rehabilitation.

[36]  J. Baron,et al.  Motor Imagery: A Backdoor to the Motor System After Stroke? , 2006, Stroke.

[37]  P. Eriksson,et al.  On neural plasticity, new neurons and the postischemic milieu: An integrated view on experimental rehabilitation , 2006, Experimental Neurology.

[38]  Gert Kwakkel,et al.  Impact of Time on Improvement of Outcome After Stroke , 2006, Stroke.