Summary of findings 1. Summary of findings for the main comparison. Motor imagery compared to other therapies (control) for gait rehabilitation after stroke (only outcomes immediately after intervention).
Motor imagery compared to other therapies (control) for gait rehabilitation after stroke (only outcomes immediately after intervention) | ||||||
Patient or population: People performing gait rehabilitation after stroke Setting: Clinical and home environment Intervention: MI Comparison: Other therapies (control) | ||||||
Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
Risk with control | Risk with MI | |||||
Walking speed assessed with: 10MWT test, custom systems | ‐ | The mean walking speed in the intervention groups was0.44 standard mean difference higher (0.06 to 0.81 higher) | ‐ | 191 (6 RCTs) | ⊕⊝⊝⊝ very lowa,b,c | Evidence suggests that MI may increase walking speed |
Motor function assessed with: FMA‐LE | ‐ | The mean motor function in the intervention groups was 2.24mean difference higher (1.20 lower to 5.69 higher) | ‐ | 130 (3 RCTs) | ⊕⊝⊝⊝ very lowa,b,c,d | MI results show little or no difference in motor function |
Functional mobility assessed with: RMI, TUGT | ‐ | The mean functional mobility in the intervention groups was 0.55 standard mean difference higher (0.45 lower to 1.56 higher) | ‐ | 116 (4 RCTs) | ⊕⊝⊝⊝ very lowa,b,c,d | MI results show in little or no difference in functional mobility |
Dependence on personal assistance assessed with: MAS, BI, FAC | See comment | Not estimable | 385 (10 RCTs) | ‐ | Due to the lack of data in the studies regarding this outcome it was not possible to perform the meta‐analysis | |
Walking endurance assessed with: 6MWT | See comment | ‐ | 30 (1 RCT) | ‐ | Due to not reaching the minimum number of studies (2), it was not possible to perform the meta‐analysis | |
Adverse events (including pain, falls and all‐cause deaths) | See comment | Not estimable | 252 (7 RCTs) | ‐ | No adverse events were related to the interventions | |
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). 6MWT: 6 Minute Walk Test; 10MWT: 10 Meter Walk Test; BI: Barthel Index; CI: confidence interval; FAC: Functional Ambulation Category; FIM: Functional Independence Measure; FMA‐LE: Fugl‐Meyer Assessment Lower Extremity; MAS: Motor Assessment Scale; MI: motor imagery; RMI: Rivermead Mobility Index; RR: risk ratio; TUGT: Timed Up and Go Test | ||||||
GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect |
aDowngraded due to several ratings with 'high' or 'unclear' risk of bias for random sequence generation, allocation concealment or blinding of outcome assessment.
bSmall sample size (< 400).
cWide confidence interval.
dModerate or substantial heterogeneity (> 50%).