{ "abstract": "Background\n\nPost-stroke pain is a common and intractable complication that hinders neurorehabilitation progress. Motor Guided Imagery (MGI), an emerging rehabilitation technique based on brain-computer interaction principles, has shown potential in relieving post-stroke pain, yet high-quality evidence on its multi-dimensional efficacy remains insufficient. This study aimed to systematically evaluate the effects of MGI on pain, sensorimotor function, sleep quality, life status, and psychological mood in stroke patients using a three-level meta-analysis.Objective\n\nThis study aimed to quantitatively assess the therapeutic effects of Motor Guided Imagery for stroke-related pain and explore potential intervention moderators using a three-level meta-analysis framework.Methods\n\nEight Chinese and English databases were searched from inception to June 29, 2025, to collect randomized controlled trials (RCTs) of MGI for stroke patients with pain. A three-level random-effects model was adopted to pool Hedges' g effect sizes, accompanied by heterogeneity testing, moderator analysis, influence analysis, and publication bias assessment. Influence-based outlier detection was implemented; analyses retaining all effect-size observations were treated as the primary main analysis, while outlier-removed analyses were reported only as supplementary sensitivity checks.Results\n\nMotor-guided imagery training significantly relieved pain (g = -0.524, 95% CI -0.779 to -0.269, p = 0.0006; negative Hedges' g indicates clinical improvement for this outcome) and improved sleep quality (g = -1.658, 95% CI -2.115 to -1.201, p < 0.001; negative Hedges' g indicates clinical improvement for this outcome) in stroke patients. Meanwhile, it significantly enhanced motor function (g = 1.395, 95% CI 0.963 to 1.826, p < 0.001), life status (g = 1.757, 95% CI 0.966 to 2.549, p = 0.0012), and psychological-emotional status (g = 1.729, 95% CI 1.045 to 2.413, p = 0.0002); positive Hedges' g indicates clinical improvement for the latter three outcomes. Moderator analysis indicated that acute-phase intervention (≤4 weeks) and high-frequency regimens (>5 sessions/week) tended to produce better analgesic effects, while age, gender, single-session duration, and pain location had no significant moderating effects.Conclusion\n\nMGI may produce beneficial rehabilitation effects that can alleviate post-stroke pain and synergistically improve motor function, sleep, daily-living ability, and psychological state of stroke patients. Exploratory subgroup trends indicated potentially larger effects for early implementation within the acute phase and high-frequency short-duration regimens. However, these observations should be interpreted as hypothesis-generating clues given non-significant overall moderator tests. Further high-quality research is required to confirm these findings.Registration\n\nThe systematic review protocol was retrospectively registered with PROSPERO under registration ID CRD420261278812, after literature search and full-text screening had been completed.Systematic review registration\n\nhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420261278812; identifier: CRD420261278812.", "abstract_shown": true, "affiliations": [ "Institute of Physical Education and Training, Capital University of Physical Education and Sports, Beijing, China.", "School of Recreation and Community Sport, Capital University of Physical Education and Sports, Beijing, China.", "The High School Affiliated to Beijing Jiaotong University, Beijing, China, 3Shenyang Normal University, Beijing, China.", "College of Sports Science, Shenyang Normal University, Shenyang, China.", "School of Ice‑Snow Sports, Capital University of Physical Education and Sports, Beijing, China." ], "article_type": "systematic review", "arxiv": null, "author_total": 5, "authors": [ { "affs": [ 0 ], "name": "Xinmo Li" }, { "affs": [ 1 ], "name": "Hong Ni" }, { "affs": [ 2 ], "name": "Guangze Cui" }, { "affs": [ 3 ], "name": "Chen Wei" }, { "affs": [ 4 ], "name": "Yongguo Zhu" } ], "bibtex": "https://research.draconitic.com/paper/ese5kz33qnrwx.bib", "cited_by": 0, "doi": "10.3389/fneur.2026.1920523", "fulltext_url": "https://europepmc.org/articles/PMC13682273", "id": "ese5kz33qnrwx", "issns": [ "1664-2295" ], "landing_url": "https://europepmc.org/article/MED/42904129", "language": "eng", "licence": "CC-BY", "licence_label": "CC BY", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "openalex", "2742|Stroke Rehabilitation and Recovery" ] ], "openalex": "W7220742987", "pdf_url": "https://europepmc.org/articles/PMC13682273?pdf=render", "pmcid": "PMC13682273", "pmid": "42904129", "published": "2026-10-06", "publisher": "Frontiers Media SA", "ris": "https://research.draconitic.com/paper/ese5kz33qnrwx.ris", "sources": [ { "first_seen": "2026-10-30T12:19:57Z", "native_id": "MED:42904129", "source": "europepmc", "url": "https://europepmc.org/article/MED/42904129" }, { "first_seen": "2026-10-30T12:20:16Z", "native_id": "10.3389/fneur.2026.1920523", "source": "crossref", "url": "https://www.frontiersin.org/articles/10.3389/fneur.2026.1920523/full" } ], "subjects": [ { "field": "medicine", "origin": "issn:1664-2295", "subfield": "neurology" } ], "title": "Impact of motor guided imagery therapy on stroke patients with pain symptoms: a three-level meta-analysis and systematic review of randomized controlled trials.", "title_text": "Impact of motor guided imagery therapy on stroke patients with pain symptoms: a three-level meta-analysis and systematic review of randomized controlled trials.", "type": "peer-reviewed", "updated_at": "2026-10-30T12:20:16Z", "url": "https://research.draconitic.com/paper/ese5kz33qnrwx", "venue": "Frontiers in neurology", "versions": [] }