Effects of motor imagery training on gait performance in individuals after stroke: a systematic review and meta-analysis

Abstract

Purpose

This review systematically explores and summarise the effects of motor imagery training (MIT) compared to conventional therapy on gait performance in individuals after stroke.

Materials and methods

Randomised controlled trials (RCTs) were systematically searched in five electronic databases (PubMed, EMBASE, PsycINFO, OVID Nursing and CINAHL) from inception to 30 December 2022. Studies investigating MITs, targeted at individuals after stroke were eligible. Data were extracted related to study and intervention characteristics.

Results

Sixteen studies were included. Compared with ‘routine methods of treatment or training’, the meta-analyses showed that MIT was more effective in improving cadence immediately post intervention (SMD: 1.22, 95% CI: 0.59, 1.85, p = 0.0001, I² = 25%) and at 1- or 2-months post intervention (SMD: 0.78, 95% CI: 0.35, 1.20, p = 0.0004, I² = 46%). The results also showed that MIT improves the step length of the affected side and the unaffected side at 1- or 2-months post intervention. Separate meta-analyses were also conducted on different tests of walking endurance (assessed by the 6-Minute Walk Test) and functional mobility (assessed by the Timed-Up-and-Go test).

Conclusions

MIT effectively improved gait performance. The findings in individuals after stroke remain inconclusive due to significant heterogeneity in included studies.

IMPLICATIONS FOR REHABILITATION

• Restoring gait performance and daily functional abilities is an important goal of post-stroke rehabilitation.

• Motor imagery training (MIT) may be a promising method to improve gait restoration and is expected to provide another option for the effective rehabilitation of stroke patients.

• This review highlights the limited research on MIT and thus the limited evidence to guide clinical rehabilitation.

• In the stroke rehabilitation, clinical specialists may consider incorporating MIT into the treatment programme to improve patients’ gait performance and ensure effective early lower limb rehabilitation.

Keywords:

• Stroke
• Motor imagery
• Mental practice
• Gait performance
• Gait parameters
• Meta-analysis

Ethics approval

All procedures were in accordance with the guidelines of the Research Ethics Committee of the University (Approval number: IRB00001052-22116). This study was in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments.

Patient and public involvement

Patients and/or the public were not involved in the design, conduct, reporting or dissemination plans of this research.

Patient consent for publication

Not applicable.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This review was supported by National Natural Science Foundation of China [Grant No. 72074008].