Updates on Motor Imagery and Action Observation in Parkinson's Disease Motor Rehabilitation: A Systematic Review and Meta-analysis.

BackgroundMotor imagery (MI) and action observation (AO) are promising interventions in the rehabilitation of people with Parkinson's disease (PD), especially in motor symptoms.ObjectiveSystematically review studies using MI and AO protocols to assess motor symptoms in people with PD.MethodsThe search was performed in the principal databases, including randomized controlled trials (RCTs) and pilot studies published in the last 10 years. Studies should include the Unified Parkinson's Disease Rating Scale (UPDRS) part III - motor assessment as the primary outcome. The PEDro Scale was used to assess the methodological quality. Data were reported as mean difference (MD) and 95% confidence interval (CI).ResultsSix studies were included, 152 participants with PD (63.8% men, with ages ranging from 45.3 to 88 years). In the meta-analysis, no differences were found in the main outcome either in the "on" medication state (MD = -0.81; 95% CI = -6.20 to 4.58; p = 0.77; n = intervention: 43/comparator: 43; studies = 4; I2 = 28%) or "off" state (MD = 0.53; 95% CI = -2.74 to 3.79; p = 0.75; n = intervention: 47/comparator: 47; studies = 3; I2 = 0).ConclusionThe applicability of MI and AO is diverse, but there is a lack of studies combining both interventions, especially with outcomes for the upper limbs.