A Systematic Review of the Effectiveness of Guided Motor Imagery in Managing Multiple Sclerosis Symptoms
Purpose: Motor imagery (MI) is the mental practice of physical skills and tasks without the involvement in physical practice. MI may be used as a rehabilitative intervention and is gaining recognition as an effective and valuable method of treatment for a variety of diagnoses. As a rehabilitative tool, participants are to imagine themselves successfully carrying out the desired skills and tasks in order to activate the brain’s neuroplastic properties into fostering neuromusculoskeletal re-education and improving functional mobility. Largely, research has focused on MI as an intervention technique for the populations of stroke, Parkinson’s, and orthopedic return to sport. The aim of this systematic review is to ascertain the effectiveness and clinical utility of MI in rehabilitating the most common symptoms in Multiple Sclerosis (MS), such as fatigue, anxiety, cognitive decline, and diminished functional mobility. This study will summarize the pre-existing and relevant literature and increase the statistical power of smaller studies to identify motor imagery’s treatment outcomes within MS rehabilitation.
Subjects: The selected studies included populations that comprised of males and females, ages ranging between 18 and 76 years old, all with diagnosed MS. Our systematic review article selection did not discriminate between the types of MS diagnosed. Further, the forms of MI included within the selected studies involved guided imagery, rhythmic cued imagery via music or metronome, or self-generated imagery. The chosen studies varied in their frequencies and durations of intervention sessions; with a range of only 2 sessions up to 5 weeks of intervention trials.
Methods: Systematic searches were conducted in 6 electronic databases and engines. Only articles focusing on MS and MI or mental practice were included. Methodological quality of the selected studies was assessed via a topic-specific screening form similar to the PEDro. 8 published studies met the inclusion criteria for this SRA.
Results: MI presented significant effects upon decreasing the levels of fatigue and anxiety (3 studies), improving timed gait scores (1 study), and improving autobiographical memory (3 studies). No significant changes were seen in the Expanded Disability Status Scale (EDSS) or the Multiple Sclerosis Functional Composite (MSFC).
Conclusions: The results suggest that MI alone may be effective in improving mood states, fatigue levels, and functional mobility of those diagnosed with MS. Further studies are needed to confirm the benefits of MI in general functional mobility within an MS population.
Clinical Relevance: Given the efficacy of MI in managing the most common symptoms of MS, MI may be indicated in rehabilitation settings to improve the symptomology of patients with MS. MI specifically provides a cost-effective, safe, and relatively quick improvement within people diagnosed with MS that may assist in the return to desired recreational and occupational activities.