{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T10:20:36Z","timestamp":1769163636882,"version":"3.49.0"},"reference-count":40,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Vestibular disorders significantly impact people\u2019s quality of life, affecting functions such as balance and walking. Current treatments involve pharmacological and non-pharmacological approaches, with vestibular rehabilitation proving effective in helping to compensate for deficits. Although traditional techniques address various aspects of the vestibular system, many fundamental studies suggest motor imagery could reduce vestibular impairment. Despite the paucity of research on motor imagery for vestibular disorder rehabilitation, recent expert recommendations suggest it could enhance functional recovery. This review questions the evidence in the literature on the clinical value benefits of motor imagery as part of vestibular rehabilitation. The aims of this study were 1. to identify motor imagery interventions used in the literature, 2. to critically appraise them, and 3. to report their impact on clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a systematic search using the PubMed, Cochrane Library, Web Of Science, CINAHL and Scopus databases. The review was registered on PROSPERO and is reported according to the PRISMA guidelines. PICO criteria were adults undergoing a motor imagery intervention as part of vestibular rehabilitation, studies with or without comparators, and the use of clinical outcome measures. A critical grid was completed, and a risk of bias assessment was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Despite identifying 2404 (after duplicate removal) concerning motor imagery and vestibular rehabilitation, only two articles met our inclusion criteria. Our findings suggest a clinical benefit of integrating motor imagery into vestibular rehabilitation. However, the limited evidence and methodological shortcomings warrant caution, including small sample size, absence of imagery quality assessment, and poor generalizability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Future research should address the identified limitations, including the need to study a broader range of vestibular pathologies, use comprehensive assessments, and evaluate long-term effects. This would contribute to a more thorough understanding of motor imagery as part of vestibular rehabilitation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>PROSPERO CRD42023444673<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0337445","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T18:22:02Z","timestamp":1769106122000},"page":"e0337445","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evidence for motor imagery in the management of vestibular disorders does not support recent guidelines: A systematic search and review"],"prefix":"10.1371","volume":"21","author":[{"given":"Dimitri","family":"Fabre-Adinolfi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florian","family":"Naye","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2205-132X","authenticated-orcid":true,"given":"Thomas","family":"Rulleau","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,1,22]]},"reference":[{"issue":"11","key":"pone.0337445.ref001","doi-asserted-by":"crossref","first-page":"1604","DOI":"10.1111\/j.1742-1241.2009.02104.x","article-title":"The challenges of managing vestibular disorders: a qualitative study of clinicians\u2019 experiences associated with low referral rates for vestibular rehabilitation","volume":"63","author":"SH Polensek","year":"2009","journal-title":"Int J Clin Pract"},{"issue":"6","key":"pone.0337445.ref002","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1016\/0959-4388(94)90137-6","article-title":"Postural control system","volume":"4","author":"J Massion","year":"1994","journal-title":"Curr Opin Neurobiol"},{"issue":"6","key":"pone.0337445.ref003","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1016\/j.neucli.2008.09.011","article-title":"Vestibular rehabilitation therapy","volume":"38","author":"FC Boyer","year":"2008","journal-title":"Neurophysiol Clin"},{"key":"pone.0337445.ref004","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1016\/j.ejphar.2015.11.041","article-title":"Comparative analysis of pharmacological treatments with N-acetyl-DL-leucine (Tanganil) and its two isomers (N-acetyl-L-leucine and N-acetyl-D-leucine) on vestibular compensation: Behavioral investigation in the cat","volume":"769","author":"B Tighilet","year":"2015","journal-title":"Eur J Pharmacol"},{"issue":"1","key":"pone.0337445.ref005","article-title":"Vestibular rehabilitation for unilateral peripheral vestibular dysfunction","volume":"1","author":"MN McDonnell","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"issue":"2","key":"pone.0337445.ref006","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1097\/NPT.0000000000000120","article-title":"Vestibular rehabilitation for peripheral vestibular hypofunction: an evidence-based clinical practice guideline: from the american physical therapy association neurology section","volume":"40","author":"CD Hall","year":"2016","journal-title":"J Neurol Phys Ther"},{"issue":"3","key":"pone.0337445.ref007","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1007\/s11659-012-0313-4","article-title":"\u00c9valuation et r\u00e9\u00e9ducation vestibulaire","volume":"28","author":"C Monseau","year":"2012","journal-title":"Lett Med Phys Readapt"},{"issue":"5","key":"pone.0337445.ref008","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/j.aorl.2008.06.003","article-title":"Physiological bases and practices in vestibular rehabilitation","volume":"125","author":"PTB Huy","year":"2008","journal-title":"Ann Otolaryngol Chir Cervicofac"},{"issue":"7","key":"pone.0337445.ref009","doi-asserted-by":"crossref","first-page":"942","DOI":"10.2522\/ptj.20060331","article-title":"Motor imagery in physical therapist practice","volume":"87","author":"R Dickstein","year":"2007","journal-title":"Phys Ther"},{"key":"pone.0337445.ref010","doi-asserted-by":"crossref","first-page":"285","DOI":"10.3389\/fneur.2014.00285","article-title":"Interaction between vestibular compensation mechanisms and vestibular rehabilitation therapy: 10 recommendations for optimal functional recovery","volume":"5","author":"M Lacour","year":"2015","journal-title":"Front Neurol"},{"key":"pone.0337445.ref011","first-page":"397","article-title":"Clinical applications of motor imagery in rehabilitation","volume-title":"Multisensory Imagery","author":"F Malouin","year":"2012"},{"key":"pone.0337445.ref012","doi-asserted-by":"crossref","DOI":"10.1006\/nimg.2001.0832","article-title":"Neural simulation of action: a unifying mechanism for motor cognition","volume":"14","author":"M Jeannerod","year":"2001","journal-title":"Neuroimage"},{"issue":"6","key":"pone.0337445.ref013","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1016\/S0959-4388(99)00038-0","article-title":"Mental imaging of motor activity in humans","volume":"9","author":"M Jeannerod","year":"1999","journal-title":"Curr Opin Neurobiol"},{"issue":"1","key":"pone.0337445.ref014","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1136\/jnnp.71.1.48","article-title":"Interference between postural control and mental task performance in patients with vestibular disorder and healthy controls","volume":"71","author":"L Yardley","year":"2001","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"pone.0337445.ref015","doi-asserted-by":"crossref","first-page":"14","DOI":"10.3389\/fnint.2016.00014","article-title":"Influence of Caloric Vestibular Stimulation on Body Experience in Healthy Humans","volume":"10","author":"A Sch\u00f6nherr","year":"2016","journal-title":"Front Integr Neurosci"},{"issue":"5","key":"pone.0337445.ref016","doi-asserted-by":"crossref","DOI":"10.1088\/1741-2552\/ac2a6f","article-title":"Enhancement of capability for motor imagery using vestibular imbalance stimulation during brain computer interface","volume":"18","author":"K Zhang","year":"2021","journal-title":"J Neural Eng"},{"issue":"11","key":"pone.0337445.ref017","doi-asserted-by":"crossref","first-page":"3136","DOI":"10.1016\/j.neuropsychologia.2011.07.026","article-title":"Vestibular information is necessary for maintaining metric properties of representational space: evidence from mental imagery","volume":"49","author":"P P\u00e9ruch","year":"2011","journal-title":"Neuropsychologia"},{"key":"pone.0337445.ref018","first-page":"80","article-title":"Seeing with the internal eye - how are perception and imagery connected?","volume":"11","author":"FW Mast","year":"2005","journal-title":"Neuroforum"},{"issue":"2","key":"pone.0337445.ref019","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1111\/j.1471-1842.2009.00848.x","article-title":"A typology of reviews: an analysis of 14 review types and associated methodologies","volume":"26","author":"MJ Grant","year":"2009","journal-title":"Health Info Libr J"},{"key":"pone.0337445.ref020","doi-asserted-by":"crossref","first-page":"111970","DOI":"10.1016\/j.jclinepi.2025.111970","article-title":"Overview of evidence synthesis types and modes","volume":"187","author":"B Nussbaumer-Streit","year":"2025","journal-title":"J Clin Epidemiol"},{"key":"pone.0337445.ref021","doi-asserted-by":"crossref","first-page":"101484","DOI":"10.1016\/j.cegh.2023.101484","article-title":"Introduction to the GRADE tool for rating certainty in evidence and recommendations","volume":"25","author":"M Prasad","year":"2024","journal-title":"Clinical Epidemiology and Global Health"},{"key":"pone.0337445.ref022","unstructured":"Aromataris M. The systematic review and synthesis of text and opinion data - JBI Manual for Evidence Synthesis - JBI Global Wiki. JBI. 2020. Available: https:\/\/jbi-global-wiki.refined.site\/space\/MANUAL\/4689762\/4.3+The+systematic+review+and+synthesis+of+text+and+opinion+data"},{"key":"pone.0337445.ref023","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.neuroscience.2015.01.021","article-title":"How imagery changes self-motion perception","volume":"291","author":"Y Nigmatullina","year":"2015","journal-title":"Neuroscience"},{"issue":"16","key":"pone.0337445.ref024","doi-asserted-by":"crossref","first-page":"2125","DOI":"10.1097\/00001756-200211150-00027","article-title":"Both actual and imagined locomotion suppress spontaneous vestibular nystagmus","volume":"13","author":"K Jahn","year":"2002","journal-title":"Neuroreport"},{"key":"pone.0337445.ref025","doi-asserted-by":"crossref","first-page":"103194","DOI":"10.1016\/j.nepr.2021.103194","article-title":"PICO: What it is and what it is not","volume":"56","author":"M Schiavenato","year":"2021","journal-title":"Nurse Educ Pract"},{"key":"pone.0337445.ref026","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.jclinepi.2016.01.021","article-title":"PRESS Peer Review of Electronic Search Strategies: 2015 Guideline Statement","volume":"75","author":"J McGowan","year":"2016","journal-title":"Journal of Clinical Epidemiology"},{"key":"pone.0337445.ref027","article-title":"AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both","volume":"358","author":"BJ Shea","year":"2017","journal-title":"BMJ"},{"issue":"1","key":"pone.0337445.ref028","doi-asserted-by":"crossref","first-page":"45","DOI":"10.2519\/jospt.2020.0701","article-title":"Generalizability: Linking Evidence to Practice","volume":"50","author":"SJ Kamper","year":"2020","journal-title":"J Orthop Sports Phys Ther"},{"issue":"2","key":"pone.0337445.ref029","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1177\/2150137810373613","article-title":"Statistical Power, Sampling, and Effect Sizes","volume":"1","author":"CA Sink","year":"2010","journal-title":"Counseling Outcome Research and Evaluation"},{"key":"pone.0337445.ref030","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1093\/acprof:osobl\/9780199791040.003.0004","article-title":"Validity of Statistical Conclusions","volume-title":"Validity and Validation","author":"CS Taylor","year":"2013"},{"issue":"8","key":"pone.0337445.ref031","doi-asserted-by":"crossref","first-page":"667","DOI":"10.2519\/jospt.2018.0703","article-title":"Bias: Linking Evidence With Practice","volume":"48","author":"SJ Kamper","year":"2018","journal-title":"J Orthop Sports Phys Ther"},{"key":"pone.0337445.ref032","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1007\/s00415-020-10228-4","article-title":"Vestibular rehabilitation in Europe: a survey of clinical and research practice","volume":"267","author":"D Meldrum","year":"2020","journal-title":"J Neurol"},{"key":"pone.0337445.ref033","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1186\/1741-7015-9-75","article-title":"Best practice for motor imagery: a systematic literature review on motor imagery training elements in five different disciplines","volume":"9","author":"C Schuster","year":"2011","journal-title":"BMC Med"},{"issue":"4","key":"pone.0337445.ref034","doi-asserted-by":"crossref","first-page":"203","DOI":"10.3988\/jcn.2013.9.4.203","article-title":"Bedside evaluation of dizzy patients","volume":"9","author":"Y-E Huh","year":"2013","journal-title":"J Clin Neurol"},{"issue":"2","key":"pone.0337445.ref035","doi-asserted-by":"crossref","first-page":"154","DOI":"10.4103\/jmms.jmms_25_23","article-title":"Assessment of peripheral vestibular apparatus in patients with peripheral vestibular symptoms using videonystagmography in tertiary care center","volume":"25","author":"LVM Reddy","year":"2023","journal-title":"Journal of Marine Medical Society"},{"issue":"3","key":"pone.0337445.ref036","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1080\/21695717.2017.1353774","article-title":"Clinical application of the head impulse test of semicircular canal function","volume":"15","author":"IS Curthoys","year":"2017","journal-title":"Hearing Balance and Communication"},{"key":"pone.0337445.ref037","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1113\/jphysiol.1986.sp016043","article-title":"The vestibulo-ocular reflex during human saccadic eye movements","volume":"373","author":"VP Laurutis","year":"1986","journal-title":"J Physiol"},{"issue":"5","key":"pone.0337445.ref038","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1080\/02640410903555855","article-title":"On the role of imagery modalities on motor learning","volume":"28","author":"L Toussaint","year":"2010","journal-title":"J Sports Sci"},{"issue":"4","key":"pone.0337445.ref039","first-page":"129","article-title":"Optimiser la r\u00e9cup\u00e9ration locomotrice par l\u2019imagerie motrice","author":"F Malouin","year":"2013","journal-title":"Movement & Sport Sciences"},{"issue":"3","key":"pone.0337445.ref040","doi-asserted-by":"crossref","first-page":"030201","DOI":"10.11613\/BM.2017.030201","article-title":"Dealing with the positive publication bias: Why you should really publish your negative results","volume":"27","author":"A Mlinari\u0107","year":"2017","journal-title":"Biochem Med (Zagreb)"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0337445","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T18:22:10Z","timestamp":1769106130000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0337445"}},"subtitle":[],"editor":[{"given":"Gauri","family":"Mankekar","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,1,22]]},"references-count":40,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,22]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0337445","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,22]]}}}