【論文摘要】Effects of Mental Imagery in Ambulation Ability After Stroke: A Systematic Review and Meta-analysis

【論文摘要】心像治療對於腦中風患者的行走能力之影響：系統性回顧與統合分析

魏雅瑩(Ya-Ying Wei) ； 許耀宗(Yao-Tsung Hsu) ； 李雨璇(Yu-Hsuan Li)

《物理治療》 45卷4期 (2020/12) Pp. 336-337

https://doi.org/10.6215/FJPT.202012.P30

摘要

Background: Mental imagery (MI), also known as visualization, is a subjective experience of perception without real sensory stimuli. However, current systematic reviews investigating the functional recovery of the lower extremity (LE) after receiving MI intervention is still limited. The purpose of this study was to investigate the effects of MI on functional recovery of LE in stroke patients by a systematic review. Methods: A comprehensive database search of the literature from 2010 to April 2020 was performed via Cochrane, MEDLINE, EMBASE, PubMed, Physiotherapy Evidence Database scale (PEDro). The keywords were: (1) stroke/cerebrovascular accident, (2) Motor/Mental Imagery, and (3) lower/walk/ ambulation. Randomized clinical trials which include MI intervention for improving the LE recovery of stroke patients were located. The primary outcomes were clinical assessments of ambulation ability. Two review authors (Wei and Hsu) independently assessed the risk of bias and trial quality via the Cochrane risk of bias tool and the PEDro and then synthesized the study results. Meta-analysis was performed with a fixed-effects model due to similar study in participants and outcome measures by Review Manager 5.3 software. Results: Four studies (142 stroke patients) of high-quality and low-bias were included (PEDro score ＞ 6). These studies showed that MI could promote ambulation ability recovery, which improved the performance of Timed Up-and-Go (TUG) test by 11.3-38.6%, 10-m Walk Test (10mWK) by 22.0-42.2%. The overall treatment effect was small to large for TUG standardized mean differences (SMD) 0.10 (95% CI: -0.57-0.36), Chi^2 = 0.78 (p = 0.38), I^2 = 0%, and 10mWK SMD 1.47 (95% CI: 2.13-0.80), Chi^2 = 5.04 (p = 0.02), I^2 = 80%. Conclusion: This systematic review showed that MI therapy may have more positive effects on the recovery of LE motor and ambulation ability than conventional therapy for stroke patients. Due to the small number of studies and high heterogeneity of the available scientific literature, more studies are needed to determine the most effective therapy protocol. Clinical Relevance: MI could be a viable intervention for all phases of stroke patients because it is safe, cost-effective, and clinically convenient to be combined with other therapies.