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Efficacy of motor imagery in post-stroke rehabilitation: a systematic review.

Zimmermann-Schlatter A, Schuster C, Puhan MA, Siekierka E, Steurer J - J Neuroeng Rehabil (2008)

Bottom Line: 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).However, larger and methodologically sounder studies should be conducted to assess the benefits of Motor imagery.

View Article: PubMed Central - HTML - PubMed

Affiliation: Zurich University of Applied Sciences, Winterthur, Switzerland. andrea.zimmermann@zhwin.ch

ABSTRACT

Background: Evaluation 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.

Design: Systematic review of the literature

Methods: We 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.

Results: We 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).

Conclusion: Current 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.

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Related in: MedlinePlus

Flow diagram of study selection process.
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Figure 1: Flow diagram of study selection process.

Mentions: Figure 1 shows the study selection process and the reviewers' agreement on study inclusion. Our search yielded 2116 potentially relevant citations after removing duplicates. 113 articles were selected for closer evaluation. Of these, we included four RCTs [22-25]. Reasons for the exclusion of the other 109 studies were: no RCTs (n = 58), study population differed from the pre-defined study population (n = 26), MI was not used as an intervention (n = 25). The two reviewers agreed in 96% of the cases on inclusion or exclusion of the studies.


Efficacy of motor imagery in post-stroke rehabilitation: a systematic review.

Zimmermann-Schlatter A, Schuster C, Puhan MA, Siekierka E, Steurer J - J Neuroeng Rehabil (2008)

Flow diagram of study selection process.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2279137&req=5

Figure 1: Flow diagram of study selection process.
Mentions: Figure 1 shows the study selection process and the reviewers' agreement on study inclusion. Our search yielded 2116 potentially relevant citations after removing duplicates. 113 articles were selected for closer evaluation. Of these, we included four RCTs [22-25]. Reasons for the exclusion of the other 109 studies were: no RCTs (n = 58), study population differed from the pre-defined study population (n = 26), MI was not used as an intervention (n = 25). The two reviewers agreed in 96% of the cases on inclusion or exclusion of the studies.

Bottom Line: 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).However, larger and methodologically sounder studies should be conducted to assess the benefits of Motor imagery.

View Article: PubMed Central - HTML - PubMed

Affiliation: Zurich University of Applied Sciences, Winterthur, Switzerland. andrea.zimmermann@zhwin.ch

ABSTRACT

Background: Evaluation 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.

Design: Systematic review of the literature

Methods: We 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.

Results: We 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).

Conclusion: Current 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.

Show MeSH
Related in: MedlinePlus