Effectiveness of motor imagery for improving functional performance after total knee arthroplasty: a systematic review with meta-analysis

Abstract

Background The aim of this study was to appraise the effects of motor imagery on the functional performance improvement among total knee arthroplasty patients systematically. We hypothesized a relatively greater recovery in the motor imagery group. Methods Medline (Ovid), Embase and Cochrane Controlled Register of Trials (CENTRAL) were searched from inception to October 1st, 2021. We included randomized controlled trials evaluating the effects of motor imagery on the functional recovery among total knee arthroplasty patients. Measurements included range of motion, strength intensity, Visual Analogue Scale, Time Up and Go Test, Oxford Knee Score, Western Ontario and McMaster Universities Osteoarthritis Index, all of which were evaluated before and after intervention. Mean differences (MD) or standard mean differences (SMD) and 95% confidence intervals (CI) were calculated. The Cochrane risk of bias tool was used to assess the risk of bias. Results Six studies with 168 patients were included for the meta-analysis. The SMD of strength intensity was increased (SMD = 0.90, 95% CI = [0.47]–[1.32], P < 0.001). The SMD of Visual Analogue Scale was reduced (SMD = − 0.91; 95% CI = [− 1.29]–[− 0.52], P < 0.001). The SMD of Time Up and Go Test was reduced (SMD = − 0.56, 95% CI = [− 0.94]–[− 0.19], P = 0.003). The MD of Oxford Knee Score was slightly increased (MD = 0.79-point, 95% CI = [− 0.31]–[1.88], P = 0.159). The outcomes of range of motion, Western Ontario and McMaster Universities Osteoarthritis Index were described according to the original data. Conclusion Compared with control therapy, motor imagery in the intervention group achieved an effective treatment for strength enhancement, pain reduction and physical activities improvement. More large-scale, prospective researches are needed in the future. Trial registration: The PROSPERO trial registration number is CRD42021250996.

The effects of preoperative rehabilitation on pain and functional outcome after total knee arthroplasty: a meta-analysis of randomized controlled trials

“…Motor imagery refers to the mental representation of body movements without obvious body movements, which can effectively improve the performance of sports [ 34 ]. A systematic review shows that motion imagery is effective in the treatment of strength enhancement, pain reduction, and improved physical activity in patients undergoing TKA [ 35 ]. The intervention time of preoperative rehabilitation is generally 4–8 weeks.…”

Deconstruction of the Prevention of Knee Osteoarthritis by Swimming Based on Data Mining Technology

“…Wang et al have conducted several clinical studies to evaluate the effect of neuromuscular exercise therapy on joint stability in patients with knee osteoarthritis [ 2 ]. Li et al, who aimed to systematically evaluate the effect of motor imagery on improvement in functional performance in patients with total knee arthroplasty, included randomized controlled trials evaluating the effect of motor imagery on motor imagery [ 3 ]. These articles have well explained the importance of protecting the knee, but they have not been studied on the basis of swimming movement under DM and have certain limitations.…”

Motor Imagery as Adjunct Therapy for Rehabilitation of Total Knee Arthroplasty Patients: The State-of-the-Art Umbrella Review with Meta-Analysis

“…Thus, all reviews assessed affected knee extension strength and timed up to go test. Two reviews assessed pain intensity assessed by Visual Analogue Scale (VAS) [10,11], while two studies assessed self-perceived knee function [9,10], and Paravlic et al [9] self-selected and brisk walking speed under dual and single tasks.…”

“…The authors showed a promising result favoring cognitive interventions over routine physical therapy alone, taking into account overall physical function, maximal strength of the affected leg, fast walking speed, timed up-to-go test and active knee joint flexion. Two other reviews were published in last 2 years that examined a similar question [10,11]. These studies focused exclusively on MI practice only and included several different measures, such as range of motion of the affected knee joint and pain intensity.…”