A Systematic Review on the Effectiveness of Mental Practice with Motor Imagery in the Neurologic Rehabilitation of Stroke Patients

ABSTRACT
Background: Mental practice with motor imagery entails an individual to symbolically rehearse a physical activity within working memory in the absence of overt body movement.  It has been proven to be useful in sports training and other skills training.  However, much is yet to be determined if the same promising results may be gained when this training method is used with persons with brain lesions, like stroke patients.  Objectives: The aim of the study is to investigate evidence for the effectiveness of mental practice with motor imagery in the neurological rehabilitation of stroke patients in improving their impairments and functional limitations, and to identify variations in mental practice protocols (duration, type of imagery employed, etc) and characteristics of participants, (age of subjects, duration of stroke prior to intervention) that may have affected the results gathered.  Methods: Literature search was accomplished with electronic databases such as Science Direct, Pub Med, Proquest, MEDLINE, CINAHL, Cochrane Library for Systematic Reviews and OVID.  Criteria used in selecting articles included (1)  Clinical controlled trials or RCTs, (2) adult stroke patients, except with cerebellar or basal ganglia pathology, (3) intervention given was mental practice with motor imagery without external aids.  Two peer reviewers individually rated the quality of each study using checklists used by JBI.  Results:. A total of 7 articles were included for this systematic review after quality appraisal. This included 5 randomized controlled trials and 2 CCTs.  All studies reported improvement of UE function after the intervention.  Conclusion Although researches done with this intervention have yielded equivocal results, a relatively small body of evidence for mental practice with motor imagery in rehabilitation of UE of stroke patients still exists.  Future studies employing quality research endeavors with research designs at the upper levels of the hierarchy of evidence are recommended to strengthen the present evidence.