Motor imagery training improves balance and mobility outcomes in older adults: a systematic review

摘要

QuestionDoes motor imagery training improve measures of balance, mobility and falls in older adults without a neurological condition?DesignSystematic review and meta-analysis of randomised controlled trials.ParticipantsAdults aged at least 60 years and without a neurological condition.InterventionThree or more sessions of motor imagery training.Outcome measuresThe primary outcomes were balance measures (such as single leg stance and Berg Balance scale) and mobility measures (such as gait speed and the Timed Up and Go test). Falls were a secondary outcome measure. Risk of bias was evaluated using the PEDro Scale, and overall quality of evidence was assessed using the Grades of Research, Assessment, Development and Evaluation (GRADE) approach.ResultsTwelve trials including 356 participants were included in the systematic review and 10 trials (316 participants) were included in the meta-analyses. All trials included either apparently healthy participants or older adults after orthopaedic surgery. There was evidence that motor imagery training can significantly improve balance (SMD 1.03, 95% CI 0.25 to 1.82), gait speed (MD 0.13 m/s, 95% CI 0.04 to 0.22) and Timed Up and Go (MD 1.64 seconds, 95% CI 0.79 to 2.49) in older adults; however, the quality of evidence was very low to low. No data regarding falls were identified.ConclusionMotor imagery training improves balance and mobility in older adults who do not have a neurological condition. These results suggest that motor imagery training could be an adjunct to standard physiotherapy care in older adults, although it is unclear whether or not the effects are clinically worthwhile.Trial registrationPROSPERO CRD42017069954.