Diário da Espinha

Mental Imagery in Spinal Cord Injury: A Systematic Review

Abstract

Ruby Aikat and Vandana Dua

Background: The immense potential of structural and functional reorganization of central nervous system i.e., neuro-plasticity following any injury serves the key mechanism behind the recovery of sensory-motor functions. One of the ways of enhancing this reorganization is through the technique of mental imagery. Mental imagery has been studied in various neurological conditions such as stroke and spinal cord injury (SCI) and has been seen to be quite effective in bringing about functional gains. But the research and literature available, particularly in SCI, is quite diverse and inconclusive. This review was, hence, conducted with the aim of understanding the concept of mental imagery and its therapeutic potential in spinal cord injury.

Method: A systematic literature search, using PRISMA 2009 guidelines, was conducted according to the set inclusion and exclusion criteria. After the initial screening, 25 articles were finally selected for the review. These were independently reviewed by two reviewers. The articles selected included mixed designs (reviews, experimental studies and observational studies) and were published between 1990- September 2014.

Results: The review revealed that the common techniques used to study mental imagery were mental chronometry, mental rotation and questionnaires. Apart from these, the vividness of imagery perceived during movement simulation were assessed using Movement Imagery Questionnaire (MIQ), MIQ-R (Revised), Kinesthetic and Visual Imagery Questionnaire (KVIQ), Vividness of Motor Imagery Questionnaire (VMIQ), Time Dependent Motor Imagery (TDMI) screening test etc. Two types of imagery perspectives were discussed about: external (a perspective that involves primarily a visual representation of motor task, i.e., third person); and internal (involves kinesthetic and visual representation from inside, i.e., first person of the simulated movements).

Conclusion: The therapeutic benefits of mental imagery were mixed, with more weightage going towards motor recovery as compared to pain and other sensory areas. However, few questions still remained regarding the best methods of practice of mental imagery and the details of the techniques used with proper protocols.