The effect of mental imagery applied during a post-surgical or post-traumatic immobilization period: a systematic review and meta-analysis.

Abstract

Introduction: Limitations in mobility caused by pain, injury, or external immobilization can lead to adverse neuroplastic changes affecting the brain, the nervous system, and sensorimotor function. Mental imagery (MI) has been proposed as a non-invasive, low-cost intervention that may help mitigate these negative effects during periods of immobilization following surgery or trauma. This systematic review and meta-analysis aims to analyse the effects of MI applied during post-surgical or post-traumatic immobilization.

Evidence acquisition: A systematic literature search was performed in the databases PubMed, CINAHL, Web of Science, Medline, and PEDro. The methodological quality of the included studies was assessed using the PEDro scale, and the risk of bias was evaluated with the Cochrane RoB 2 tool. Only randomized controlled trials were included.

Evidence synthesis: A total of 11 studies met the inclusion criteria. Overall, the studies showed moderate methodological quality and a high risk of bias. The meta-analysis revealed a statistically significant effect on pain reduction in favour of mental imagery, with a Hedges' g of 1.187 (95% CI: 0.492 to 1.882; P=0.001). Additionally, several studies reported improvements in secondary outcomes such as range of motion, muscle strength, mental health, and quality of life.

Conclusions: MI appears to be a beneficial intervention to reduce pain in patients undergoing immobilization after surgery or trauma. Moreover, promising effects have been observed on range of motion, strength, mental health, and quality of life, supporting its inclusion as a complementary strategy in rehabilitation settings.