MOTOR IMAGERY AND ACTION OBSERVATION ON MOTOR LEARNING IN HEALTHY INDIVIDUALS AND PATIENTS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Z. Suica¹, C. Obrist², K. Wiesner², S. Huber³, K. Csiko⁴, L. Bonati^1,5,6, C. Schuster-Amft^1,7,8

¹Reha Rheinfelden, Research Department, Rheinfelden, Switzerland, ²Bern University of Applied Sciences, Department of Health Professions, Bern, Switzerland, ³Swiss Federal Institute of Technology Zurich, Department of Health Sciences and Technology, Discipline of Health Sciences and Technology, Zurich, Switzerland, ⁴UniDistance Suisse, Department of Psychology, Brig, Switzerland, ⁵University of Basel, Department of Neurology, Basel, Switzerland, ⁶University of Basel, Department of Clinical Research, Basel, Switzerland, ⁷Bern University of Applied Sciences, Department of Engineering and Information Technology, Burgdorf, Switzerland, ⁸University of Basel, Department for Sport, Exercise and Health, Basel, Switzerland

Background: The combination of Action Observation (AO) and Motor Imagery (MI) added to physical practice might be beneficial therapy option.

Purpose: We evaluated the effect of the combined intervention of AOMI on motor learning in healthy individuals and patients.

Methods: We systematically searched Cochrane Library, Embase, Medline Ovid, Physiotherapy Evidence database, PsycINFO, Scopus, SPORTDiscus, Web of Science and clinicaltrials.gov. Screening processes and data extraction were performed by two independent authors. Study methodologies were independently assessed with the Risk of Bias and the GRADE tools.

Results: The interventions of the selected 22 randomized controlled trials out of 5440 references (total 869 participants: healthy individuals, Parkinson's disease, patients after stroke, patients after total hip arthroplasty, children and students with neurological impairments) differed greatly in interventions, participants, and outcomes. Four studies were included in three meta-analyses. AOMI simultaneously and alternately compared to conventional therapy regarding dart throwing performance were both effective with SMD=0.38 (95%CI=-0.24-1.01). AOMI training compared to conventional therapy alone were effective for ball rotation performance regarding completion time (SMD=-0.32 (95%CI=-0.91-0.28)) and for error-rate (SMD=-0.21 (95%CI=-0.65-0.23)). In most studies, the first-person perspective was used for AO and MI and the kinesthetic mode for MI. The AOMI intervention lasted from 1 day to 8 weeks including 1 to 126 AOMI sessions with 3 to 630 AOMI trials.

Conclusions: Our results showed a positive effect of AO combined with MI on motor learning. So far, no final conclusion can be drawn on essential parameters (simultaneous or alternating AOMI, mode, perspective, number of trainings, intervention duration) of an AOMI intervention due to the high heterogeneity of the studies. The systematic review was registered with PROSPERO: CRD42021242812.

Implications: We recommend some aspects to be considered:
(1) use of a consistent terminology (Action Observation and Motor Imagery) for AOMI;
(2) evaluation of participants' MI ability before and after the intervention with standardized assessments;
(3) introductory sessions for AOMI before the actual AOMI training to ensure the same knowledge regarding AOMI for all participants;
(4) include control processes for the AOMI training (e.g., diary); and
(5) include follow-up assessment to explore the long-term effect of the AOMI training.

Funding acknowledgements: This study was not funded.

Keywords:
Action Observation, Motor Imagery, Motor Learning
Randomized Controlled Trial

Topics:
Disability & rehabilitation
Neurology
Musculoskeletal

Did this work require ethics approval? No

Reason: This SR is based on published data, and ethical approval is not required.