Motor imagery is defined as a cognitive process, in which a person imagines rehearsing a task without performing the physical movement (Scandola et al. 2017). Neuroimaging studies have demonstrated that motor imagery produces similar patterns of neural activation to those of motor execution, particularly in pre-motor areas such as the left intraparietal sulcus, basal ganglia and cerebellum (Scandola et al. 2017; Athanasiou et al. 2018). Neuroimaging aside, motor imagery has shown the potential to assist in motor skill learning and rehabilitation for upper limb paralysis. In particular, motor imagery stimulated cerebral reorganization and improved motor functioning in patients with stroke and Parkinson’s disease (Page et al. 2009; Sun et al. 2013). Despite increasing interest in motor imagery for rehabilitative therapy, very few studies have investigated motor imagery for SCI rehabilitation.
The methodological details and results of these studies are presented in Table 4.
Two studies authored by one group of researchers tested the use of MI in improving motor learning post SCI.
Di Rienzo et al. (2014, 2015) conducted two small studies and applied the same methodology involving SCI participants receiving MI and traditional physiotherapy compared to healthy controls performing physical practice. These studies resulted in mixed findings, however, SCI participants’ movement time and variability generally improved after MI.
Future studies should investigate the effect of completeness of the lesion on different types of MI in SCI. In addition, the effect of duration of injury, degree of autonomy, and presence of pain should be examined in relation to MI outcomes.
There is level 4 evidence (from two pre-post studies: Di Rienzo et al. 2014b, 2015) that MI treatment incorporated into physiotherapy for individuals with SCI may help to improve movement time and variability performance.