Effectiveness of the Combined Use of Motor Imagery and Action Observation Therapies in Improving Functionality: A Systematic Review and Meta-Analysis.

ObjectiveThe aim of this study was to evaluate the combined effect of motor imagery and action observation in context of functional rehabilitation and analyse their impact on different functional parameters.Data SourcesA systematic review and meta-analysis were conducted by means of bibliographic searches in the PubMed, Cochrane, Web of Science, Scopus, CINAHL, and PEDro databases until May 2025.Review MethodsRandomized clinical studies with participants older than 18 years with functional problems or limitations and combining action observation and motor imagery therapies were included. The Cochrane Risk of Bias (RoB) 2.0 tool, Covidence and R platform v4.4.2 were used to assess the quality of the included articles, selection of studies and data analysis, and meta-analysis. The protocol was registered in PROSPERO (No. CRD42024552072).ResultsNine articles were ultimately selected. The health conditions addressed included neurological and ageing-related disorders, as well as trauma. Compared with each therapy alone or with conventional therapies, the combination of motor imagery and action observation demonstrated benefits in lower and upper limb functionality, mobility, gait speed and fear of movement. Treatment protocols used varied in dosage (time and repetitions) and frequency (number of sessions per week).ConclusionsCombination of motor imagery and action observation therapies is beneficial for improving functionality, suggesting its potential value as an effective tool in the treatment of acute and chronic symptoms associated with various pathologies. However, clear standards regarding the dosages of these combined therapies are lacking.