Motor Imagery: A Resource in the Fatigue Rehabilitation for Return-to-Work in Multiple Sclerosis Patients—A Mini Systematic Review

Abstract

Fatigue is a multidimensional symptom with both physical and cognitive aspects, which can affect the quality of daily and working life activities. Motor Imagery (MI) represents an important resource for use during the rehabilitation processes, useful, among others, for job integration/reintegration, of neurological pathologies, such as Multiple Sclerosis (MS). To define the effective rehabilitation protocols that integrate MI for the reduction of fatigue in patients with MS (PwMS), a literary review was performed through August 2020. Five articles were included in the qualitative synthesis, including two feasibility pilot randomized control trials (RCTs) and 3 RCTs with good quality according to the PEDro score and a low risk of bias according to the Cochrane Collaboration tool. The literature suggested that MI, in association with rhythmic-auditory cues, may be an effective rehabilitation resource for reducing fatigue. Positive effects were observed on perceived cognitive and psychological fatigue. PwMS require greater compensatory strategies than healthy individuals, and the use of rhythmic-auditory cues may be useful for optimizing the cognitive processing of MI, which acts as an internal stimulus that is enhanced and made more vivid by outside cues. These findings provide evidence that MI is a promising rehabilitation tool for reducing fatigue in PwMS and return to work strategies.

Efficacy of Virtual Reality and Exergaming in Improving Balance in Patients With Multiple Sclerosis: A Systematic Review and Meta-Analysis

“…Multiple sclerosis (MS) is one of the most common causes of progressive neurological disability among young adults (1). Upper limb impairments, muscle weakness, spasticity, reduced functional performance, and fatigue are common clinical manifestations in patients with MS (2)(3)(4)(5)(6). A crucial impairment that might be often showed by patients with MS is balance disturbance, which could result in a higher risk of falling and reduced independence in the activities of daily living (ADLs) (7)(8)(9)(10).…”

Is hypnotic assessment relevant to neurology?

“…In patients with multiple sclerosis (MS) guided imagery increases walking speed and distance, reduces fatigue, improves the quality of life, and positively influences dynamic balance and perceived walking ability [35,36]. Imagery has also been used to identify and manage emotional aspects of MS possibly associated with symptoms worsening [37] as well as to counteract fatigue and facilitate return-to-work [38]. Fatigue is one of the greatest burdens for people with MS, is present in most of them, and is considered one of the worst symptoms by about half of patients, often disabling and interfering with daily life activity.…”

Factors and strategies affecting motor imagery ability in people with multiple sclerosis: a systematic review

“…Growing evidence has shown that exercise and physical activity are beneficial rehabilitation strategies for people with MS (pwMS) for managing symptoms, restoring function, optimising the quality of life, promoting wellness, and boosting participation in activities of daily living [4]. Recently, novel strategies such as MI have been used in pwMS [5][6][7]. Two J o u r n a l P r e -p r o o f recent systematic reviews in pwMS have demonstrated that MI shows positive effects on fatigue, walking, balance, quality of life, and return-to-work strategies [6,7].…”