title: Efficacy of motor imagery in post-stroke rehabilitation: a systematic review.
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.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Zurich University of Applied Sciences, Winterthur, Switzerland. andrea.zimmermann@zhwin.ch
authors.forename: Andrea
authors.initials: A
authors.lastname: Zimmermann-Schlatter
authors.forename: Corina
authors.initials: C
authors.lastname: Schuster
authors.forename: Milo A
authors.initials: MA
authors.lastname: Puhan
authors.forename: Ewa
authors.initials: E
authors.lastname: Siekierka
authors.forename: Johann
authors.initials: J
authors.lastname: Steurer
mesh_terms: D006801:Humans; D019018:Imagery, Psychotherapy / Q000379:methods*; D007092:Imagination / Q000502:physiology; D009068:Movement / Q000502:physiology; D009069:Movement Disorders / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D017063:Outcome Assessment, Health Care / Q000379:methods; D010291:Paresis / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D016032:Randomized Controlled Trials as Topic / Q000592:standards / Q000706:statistics & numerical data; D020521:Stroke / Q000503:physiopathology / Q000523:psychology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome