A scoping review on motor imagery-based rehabilitation: Potential working mechanisms and clinical application for cognitive function and depression

Objective: To map evidence on the characteristics, effectiveness, and potential mechanisms of motor imagery interventions targeting cognitive function and depression in adults with neurological disorders and/or mobility impairments.

Data sources: Six English databases (The Cochrane Library, PubMed, Embase, Scopus, Web of Sciences, and PsycINFO), two Chinese databases (CNKI and WanFang), and a gray literature database were searched from inception to December 2024.

Review methods: This scoping review followed the Joanna Briggs Institute Scoping Review methodology. Interventional studies that evaluated motor imagery for cognitive function and/or depression in adults with neurological disorders and/or mobility impairments were included.

Results: A total of 24 studies, primarily involving adults with cerebrovascular diseases, multiple sclerosis, and Parkinson's disease, were identified. Motor imagery was typically conducted at home/clinic, occurring 2 to 3 sessions per week for approximately 2 months, with each session lasting 20 to 30 minutes. The 62.5% of studies (n = 10) reported significant improvements in cognitive function, exhibiting moderate-to-large effect sizes (Cohen's d = 0.48-3.41), especially in memory, attention, and executive function, while 53.3% (n = 8) indicated alleviation in depression with moderate-to-large effect sizes (Cohen's d = -0.72- -2.56). Motor imagery interventions could relieve pain perception and promote beneficial neurological changes in brains by facilitating neurotrophic factor expression and activating neural circuits related to motor, emotional, and cognitive functions.

Conclusion: Motor imagery could feasibly be conducted at home, with promising effects on cognitive function and depression. More high-quality randomized controlled trials and neuroimaging techniques are needed to investigate the effects of motor imagery on neuroplasticity and brain functional reorganization, thereby aiding in the development of mechanism-driven interventions.