Effectiveness of motor imagery in postoperative outcomes after anterior cruciate ligament reconstruction

doi:10.5312/wjo.v17.i4.116521

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World Journal of Orthopedics

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Orthop. Apr 18, 2026; 17(4): 116521
Published online Apr 18, 2026. doi: 10.5312/wjo.v17.i4.116521

Effectiveness of motor imagery in postoperative outcomes after anterior cruciate ligament reconstruction

Maryam Salimi, Asma Mafhoumi, Seyedarad Mosalamiaghili, Alireza Arvin, Alireza Keshtkar, Walter Lowe, Hamideh Akbari

Maryam Salimi, Department of Orthopedic Surgery, University of Texas Health Sciences Center, McGovern Medical School, Houston, TX 77030, United States

Asma Mafhoumi, School of Medicine, Tehran University of Medical Sciences, Tehran 14155-6448, Tehrān, Iran

Seyedarad Mosalamiaghili, Hamideh Akbari, Golestan Rheumatology Research Center, Biomedical Research Institute, Golestan University of Medical Sciences, Gorgan 4918936316, Golestān, Iran

Alireza Arvin, Center for Orthopedic Trans-Disciplinary Applied Research, Tehran University of Medical Sciences, Tehran 14155-6448, Tehrān, Iran

Alireza Keshtkar, Research Center for Noncommunicable Diseases, Jahrom University of Medical Sciences, Jahrom 7414846199, Fārs, Iran

Walter Lowe, Memorial Hermann Rockets Sports Medicine Institute, University of Texas Health Sciences Center, McGovern Medical School, Houston, TX 77030, United States

Author contributions: Salimi M contributed to the design and implementation of the study and the writing of the manuscript; Mafhoumi A, Keshtkar A and Arvin A contributed to the statistical analyses; Mosalamiaghili S and Akbari H contributed to drafting the manuscript; Lowe W contributed to the revision of the manuscript; and all authors thoroughly reviewed and endorsed the final manuscript.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.

Corresponding author: Maryam Salimi, MD, Department of Orthopedic Surgery, University of Texas Health Sciences Center, McGovern Medical School, Fannin St, Houston, TX 77030, United States. salimimaryam7496@gmail.com

Received: November 17, 2025
Revised: January 4, 2026
Accepted: February 24, 2026
Published online: April 18, 2026
Processing time: 146 Days and 12.1 Hours

Core Tip

Core Tip: This article examined the impact of motor imagery (MI), a cognitive strategy involving the mental rehearsal of movement, on recovery following anterior cruciate ligament reconstruction. Across 12 randomized controlled trials (526 patients), MI was associated with reductions in postoperative pain and kinesiophobia (fear of reinjury) and with improved psychological readiness to return to sport in several studies, although findings were not consistently statistically significant. Integrating MI into conventional rehabilitation may offer additional psychological benefits and, in some cases, functional improvements after anterior cruciate ligament reconstruction. Larger, high-quality trials with standardized MI protocols are needed to clarify its clinical efficacy and optimal application in postoperative care.