Evidence of motor imagery for lower limb motor function recovery after stroke: A systematic review and meta-analysis of randomized controlled trials

Objective: To systematically evaluate the efficacy of motor imagery (MI) on lower limb function in patients with stroke based on the existing clinical studies.Methods: Eight databases were searched up from the establishment of database to November 2022 to identify eligible studies. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 2 researchers used the Cochrane Systematic Review manual to independently cross-check the quality of the included literature and extract valid data. The RevMan 5.3 statistical software was used to obtain the meta-analysis, through the mean difference (MD) and 95% confidence intervals (CI).Results: A total of seventeen studies with 939 patients were included in the systematic review. The overall quality of the included studies was moderate. Meta-analysis showed that Fugl-Meyer Assessment of the lower extremity (FMA-LE) (MD = 4.86, 95%CI: 4.31, 5.42, P < .00001), berg balance scale (MD = 6.18, 95%CI: 4.57, 7.78, P < .00001), functional ambulation category (MD = 0.87, 95%CI: 0.41, 1.32, P = .0002), and the Modified Barthel Index (MD = 6.75, 95%CI: 3.23, 10.28, P = .0002) score improved significantly in the MI group compared with the control group.Conclusions: Current evidence shows that MI could effectively improve lower limb motor function and activities of daily living in stroke patients. Due to the limitations of the number and quality of the included studies, the above conclusions need to be verified by more high-quality studies.