Motor imagery training speeds up gait recovery and decreases the risk of falls in patients submitted to total knee arthroplasty

Zapparoli, Laura; Sacheli, Lucia Maria; Seghezzi, Silvia; Preti, Matteo; Stucovitz, Elena; Negrini, Francesco; Pelosi, Catia; Ursino, Nicola; Banfi, Giuseppe; Paulesu, Eraldo

doi:10.1038/s41598-020-65820-5

Cited by 18 publications

(54 citation statements)

References 35 publications

(40 reference statements)

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“…In recent decades, MI has been made use of in several rehabilitative training procedures [ 41 , 42 ] with mixed results [ 43 ]. MI training has been also used with SCI patients with some success, suggesting its efficacy in motor recovery, for example in the rehabilitation of reach-to-grasp movements [ 44 ], improving wrist extensions [ 45 ], and, despite mixed results, in neuropathic pain reduction [ 46 ].…”

Section: Introductionmentioning

confidence: 99%

Cognitive Training Improves Disconnected Limbs’ Mental Representation and Peripersonal Space after Spinal Cord Injury

Moro

Corbella

Ionta

et al. 2021

IJERPH

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Paraplegia following spinal cord injury (SCI) affects the mental representation and peripersonal space of the paralysed body parts (i.e., lower limbs). Physical rehabilitation programs can improve these aspects, but the benefits are mostly partial and short-lasting. These limits could be due to the absence of trainings focused on SCI-induced cognitive deficits combined with traditional physical rehabilitation. To test this hypothesis, we assessed in 15 SCI-individuals the effects of adding cognitive recovery protocols (motor imagery–MI) to standard physical rehabilitation programs (Motor+MI training) on mental body representations and space representations, with respect to physical rehabilitation alone (control training). Each training comprised at least eight sessions administered over two weeks. The status of participants' mental body representation and peripersonal space was assessed at three time points: before the training (T0), after the training (T1), and in a follow-up assessment one month later (T2). The Motor+MI training induced short-term recovery of peripersonal space that however did not persist at T2. Body representation showed a slower neuroplastic recovery at T2, without differences between Motor and the Motor+MI. These results show that body and space representations are plastic after lesions, and open new rehabilitation perspectives.

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Section: Introductionmentioning

confidence: 99%

Cognitive Training Improves Disconnected Limbs’ Mental Representation and Peripersonal Space after Spinal Cord Injury

Moro

Corbella

Ionta

et al. 2021

IJERPH

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“…Motor imagery training combined with other therapeutic interventions enhances the recovery of daily living activities in the elderly [17]. Zapparoli et al reported that the patient's damaged motor function was recovered by combining motor imagery training and physical therapy [18].…”

Section: Introductionmentioning

confidence: 99%

Effects of Motor Imagery Training on Balance and Gait in Older Adults: A Randomized Controlled Pilot Study

Choi

2021

IJERPH

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The aim of this study was to demonstrate the effects of motor imagery training on balance and gait abilities in older adults and to investigate the possible application of the training as an effective intervention against fall prevention. Subjects (n = 34) aged 65 years and over who had experienced falls were randomly allocated to three groups: (1) motor imagery training group (MITG, n = 11), (2) task-oriented training group (TOTG, n = 11), and (3) control group (CG, n = 12). Each group performed an exercise three times a week for 6 weeks. The dependent variables included Path Length of center of pressure (COP)-based static balance, Berg Balance Scale (BBS) score, Timed Up and Go Test (TUG) score, which assesses a person’s mobility based on changes in both static and dynamic balance, Falls Efficacy Scale (FES) score, which evaluates changes in fear of falls, and gait parameters (velocity, cadence, step length, stride length, and H-H base support) to evaluate gait. After the intervention, Path Length, BBS, TUG, velocity, cadence, step length, and stride length showed significant increases in MITG and TOTG compared to CG (p < 0.05). Post hoc test results showed a significantly greater increase in BBS, TUG, and FES in MITG compared with TOTG and CG (p < 0.05). Our results suggest that motor imagery training combined with functional training has positive effects on balance, gait, and fall efficacy for fall prevention in the elderly.

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“…Core outcome sets are agreed minimum sets of outcomes that should be reported in research in a given topic area. 61 For each SoE assessment, we considered the number of studies, their designs and limitations (i.e., risk of bias and overall methodological quality), the directness of the evidence to the KQs (direct/indirect), the consistency (consistent/inconsistent) of study results, the precision (precise/imprecise) of any estimates of effect, the likelihood of reporting bias, other limitations, and the overall findings across studies. We also assessed the extent to which different (p)rehabilitation interventions were replicated within each KQ (replicated/not replicated interventions).…”

Section: Grading the Strength Of The Body Of Evidencementioning

confidence: 99%

“…Specific exercise components within rehabilitation goal components varied across programs. Nine studies included an adjunctive modality in combination with the rehabilitation program: two (Li 2014 andLi 2017) with the same adjunctive modalities delivered to both study arms and seven , Eymir 2020, Stevens-Lapsley 2012, Tsukada 2018, Jin 2018, Rockstroh 2010, Zapparoli 2020 where the added benefit of adjunctive therapy was the question of interest and the adjuvant modality varied between arms. The adjunctive modalities evaluated in these seven studies included neuromuscular electrical stimulation (NMES; n=3 RCTs); transcutaneous electrical nerve stimulation (TENS; n=1 RCT), biofeedback (n=1 RCT), motor imagery (n=1 RCT), and continuous passive motion (vs. active-heel slides which was the comparison of interest for this review) (n=1 RCT).…”

Section: Acute-phase Rehabilitationmentioning

confidence: 99%

Prehabilitation and Rehabilitation for Major Joint Replacement

Konnyu¹,

Thoma²,

Bhuma³

et al. 2021

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Objectives. This systematic review evaluates the rehabilitation interventions for patients who have undergone (or will undergo) total knee arthroplasty (TKA) or total hip arthroplasty (THA) for the treatment of osteoarthritis. We addressed four Key Questions (KQs): comparisons of (1) rehabilitation prior (“prehabilitation”) to TKA versus no prehabilitation, (2) comparative effectiveness of different rehabilitation programs after TKA, (3) prehabilitation prior to THA versus no prehabilitation, (4) comparative effectiveness of different rehabilitation programs after THA. Data sources and review methods. We searched Medline®, PsycINFO®, Embase®, the Cochrane Register of Clinical Trials, CINAHL®, Scopus®, and ClinicalTrials.gov from Jan 1, 2005, to May 3, 2021, to identify randomized controlled trials (RCTs) and adequately adjusted nonrandomized comparative studies (NRCSs). We evaluated clinical outcomes selected with input from a range of stakeholders. We assessed the risk of bias and evaluated the strength of evidence (SoE) using standard methods. Meta-analysis was not feasible, and evidence was synthesized and reported descriptively. The PROSPERO protocol registration number is CRD42020199102. Results. We found 78 RCTs and 5 adjusted NRCSs. Risk of bias was moderate to high for most studies. • KQ 1: Compared with no prehabilitation, prehabilitation prior to TKA may increase strength and reduce length of hospital stay (low SoE) but may lead to comparable results in pain, range of motion (ROM), and activities of daily living (ADL) (low SoE). There was no evidence of an increased risk of harms due to prehabilitation (low SoE). • KQ 2: Various rehabilitation interventions after TKA may lead to comparable improvements in pain, ROM, and ADL (low SoE). Rehabilitation in the acute phase (initiated within 2 weeks of surgery) may lead to increased strength (low SoE) but result in similar strength when delivered in the post-acute phase (low SoE). No studies reported evidence of risk of harms due to rehabilitation delivered in the acute period following TKA. Compared with various controls, post-acute rehabilitation may not increase the risk of harms (low SoE). • KQ 3: For all assessed outcomes, there is insufficient (or no) evidence addressing the comparison between prehabilitation and no prehabilitation prior to THA. • KQ 4: Various rehabilitation interventions after THA may lead to comparable improvements in pain, strength, ADL, and quality of life. There is some evidence of no increased risk of harms due to the intervention (low SoE). • There is insufficient evidence regarding which patients may benefit from (p)rehabilitation for all KQs and insufficient evidence regarding comparisons of different providers and different settings of (p)rehabilitation for all KQs. There is insufficient evidence on costs of (p)rehabilitation and no evidence on cost effectiveness for all KQs. Conclusion. Despite the large number of studies found, the evidence regarding various prehabilitation programs and comparisons of rehabilitation programs for TKA and THA is ultimately sparse. This is a result of the diversity of interventions studied and outcomes reported across studies. As a result, the evidence is largely insufficient or of low SoE. New high-quality research is needed, using standardized intervention terminology and core outcome sets, especially to allow network meta-analyses to explore the impact of intervention attributes on patient-reported, performance-based, and healthcare-utilization outcomes.

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Motor imagery training speeds up gait recovery and decreases the risk of falls in patients submitted to total knee arthroplasty

Cited by 18 publications

References 35 publications

Cognitive Training Improves Disconnected Limbs’ Mental Representation and Peripersonal Space after Spinal Cord Injury

Cognitive Training Improves Disconnected Limbs’ Mental Representation and Peripersonal Space after Spinal Cord Injury

Effects of Motor Imagery Training on Balance and Gait in Older Adults: A Randomized Controlled Pilot Study

Prehabilitation and Rehabilitation for Major Joint Replacement

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