Motor Imagery Training Improves Balance and Mobility Outcomes in Older Adults: A Systematic Review

Author: Vaughan Nicholson, Naomi Watts, Yannick Chani, Justin Wl Keogh
Author Information:
1 School of Allied Health, Australian Catholic University, Brisbane, Australia. Electronic address:
2 Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia.
3 Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia; Human Potential Centre, AUT University, Auckland, New Zealand; Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Conference/Journal: Journal of physiotherapy
Date published: 2019 Oct
Other: Volume ID: 65 , Issue ID: 4 , Pages: 200-207 , Special Notes: doi: 10.1016/j.jphys.2019.08.007. , Word Count: 270

PMID: 31521556 DOI: 10.1016/j.jphys.2019.08.007

Question: Does motor imagery training improve measures of balance, mobility and falls in older adults without a neurological condition?

Design: Systematic review and meta-analysis of randomised controlled trials.

Participants: Adults aged at least 60 years and without a neurological condition.

Intervention: Three or more sessions of motor imagery training.

Outcome measures: The 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.

Results: Twelve 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.

Conclusion: Motor 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 registration: PROSPERO CRD42017069954.

Keywords: Aged; Gait; Motor skills; Postural balance; Rehabilitation.

Copyright © 2019 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.