**2.2 Translations**

Motor: "motor"[All Fields] OR "motor's"[All Fields] OR "motoric"[All Fields] OR "motorically"[All Fields] OR "motorics"[All Fields] OR "motoring"[All Fields] OR "motorisation"[All Fields] OR "motorized"[All Fields] OR "motorization"[All Fields] OR "motorized"[All Fields] OR "motors"[All Fields].

Imagery: "imageries"[All Fields] OR "imagery, psychotherapy"[MeSH Terms] OR ("imagery"[All Fields] AND "psychotherapy"[All Fields]) OR "psychotherapy imagery"[All Fields] OR "imagery"[All Fields].

Mental: "mental"[All Fields] OR "mentalities"[All Fields] OR "mentality"[All Fields] OR "mentalization"[MeSH Terms] OR "mentalization"[All Fields] OR "mentalizing"[All Fields] OR "mentalize"[All Fields] OR "mentalized"[All Fields] OR "mentally"[All Fields].

Simulation: "computer simulation"[MeSH Terms] OR ("computer"[All Fields] AND "simulation"[All Fields]) OR "computer simulation"[All Fields] OR "simulation"[All Fields] OR "simul"[All Fields] OR "simulate"[All Fields] OR "simulated"[All Fields] OR "simulates"[All Fields] OR "simulating"[All Fields] OR "simulation's"[All Fields] OR "simulational"[All Fields] OR "simulations"[All Fields] OR "simulative"[All Fields] OR "simulator"[All Fields] OR "simulator's"[All Fields] OR "simulators"[All Fields].

Imagery: "imageries"[All Fields] OR "imagery, psychotherapy"[MeSH Terms] OR ("imagery"[All Fields] AND "psychotherapy"[All Fields]) OR "psychotherapy imagery"[All Fields] OR "imagery"[All Fields].

Total knee replacement: "arthroplasty, replacement, knee"[MeSH Terms] OR ("arthroplasty"[All Fields] AND "replacement"[All Fields] AND "knee"[All Fields]) OR "knee replacement arthroplasty"[All Fields] OR ("total"[All Fields] AND "knee"[All Fields] AND "replacement"[All Fields]) OR "total knee replacement"[All Fields].

*Motor Imagery as Adjunct Therapy for Rehabilitation of Total Knee Arthroplasty Patients… DOI: http://dx.doi.org/10.5772/intechopen.106388*

Total knee arthroplasty: "arthroplasty, replacement, knee"[MeSH Terms] OR ("arthroplasty"[All Fields] AND "replacement"[All Fields] AND "knee"[All Fields]) OR "knee replacement arthroplasty"[All Fields] OR ("total"[All Fields] AND "knee"[All Fields] AND "arthroplasty"[All Fields]) OR "total knee arthroplasty"[All Fields].

Physical: "physical examination"[MeSH Terms] OR ("physical"[All Fields] AND "examination"[All Fields]) OR "physical examination"[All Fields] OR "physical"[All Fields] OR "physically"[All Fields] OR "physicals"[All Fields].

Function: "functional"[All Fields] OR "functional's"[All Fields] OR "functionalities"[All Fields] OR "functionality"[All Fields] OR "functionalization"[All Fields] OR "functionalizations"[All Fields] OR "functionalize"[All Fields] OR "functionalized"[All Fields] OR "functionalizes"[All Fields] OR "functionalizing"[All Fields] OR "functionally"[All Fields] OR "functionals"[All Fields] OR "functioned"[All Fields] OR "functioning"[All Fields] OR "functionings"[All Fields] OR "functions"[All Fields] OR "physiology"[Subheading] OR "physiology"[All Fields] OR "function"[All Fields] OR "physiology"[MeSH Terms].

Strength: "strength"[All Fields] OR "strengths"[All Fields].

Rehabilitation: "rehabilitant"[All Fields] OR "rehabilitant's"[All Fields] OR "rehabilitants"[All Fields] OR "rehabilitate"[All Fields] OR "rehabilitated"[All Fields] OR "rehabilitates"[All Fields] OR "rehabilitating"[All Fields] OR "rehabilitation"[MeSH Terms] OR "rehabilitation"[All Fields] OR "rehabilitations"[All Fields] OR "rehabilitative"[All Fields] OR "rehabilitation"[Subheading] OR "rehabilitation's"[All Fields] OR "rehabilitational"[All Fields] OR "rehabilitator"[All Fields] OR "rehabilitators"[All Fields].

Outcomes: "outcome"[All Fields] OR "outcomes"[All Fields].

Systematic review: "systematic review"[Publication Type] .or. "systematic reviews as topic"[MeSH Terms] .or. "systematic review"[All Fields].

Literature review: "review"[Publication Type] .or. "review literature as topic"[MeSH Terms] .or. "literature review"[All Fields].

Meta-analysis: "meta-analysis"[Publication Type] .or. "meta-analysis as topic"[MeSH Terms] .or. "meta-analysis"[All Fields] A several additional strategies were used to find any additional reference relevant to this topic as follows:


Duplicates were identified and removed by two reviewers separately (AP and KD). Two reviewers (AP and KD) independently screened titles and abstracts to identify articles that matched the eligibility criteria.

#### **2.3 Inclusion criteria**

The Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR – 2) rating system was applied to rate and classify all published systematic reviews and


**Table 1.**

*Inclusion criteria.*

meta-analyses into low quality (< 40% items satisfied), moderate quality (40–80% items satisfied) or high quality (>80% items satisfied) [14]. Only systematic reviews with meta-analysis of moderate- and high-quality were included in the present study. Published reviews were included regardless of the original language they were written. There were no restrictions considering a year of publication.

The Participant-Intervention-Comparison-Outcome process for evidence-based practice was followed to describe inclusion criteria **Table 1**.

### **2.4 Methodological quality and quality of evidence evaluation**

The main author assessed the methodological quality of the included articles using the AMSTAR – 2 tool. If the assessment was unclear, the consensus was reached by the constructive discussion with a second reviewer (KD). The 16 items of the AMSTAR – 2 checklist were answered with either "yes" or "no", with each "yes" equaling one point and were classified as mentioned above. In addition, an adapted Grade of Recommendation, Assessment, Development and Evaluation (GRADE) quality of evidence checklist was applied in the included reviews, as it was used previously [15]. The reviews were classified into five GRADE categories: high, moderate, low, very low and no evidence from systematic review. A review was classified as high quality if it contained at least two high-quality studies. Reviews with at least one study of high quality or two studies of moderate quality were classified as moderate quality. If a review contained only primary studies of moderate quality and/ or primary studies with inconsistent results, this review was classified as being of low quality. Reviews are classified as of very low quality if they do not contain studies of moderate to high quality. Finally, if the quality of the primary studies was not assessed by the reviewers, the GRADE system was not applied and the review was classified as no evidence from systematic review as recommended previously [15].

#### **2.5 Data extraction**

The following data were extracted from the reviews included (a) Study reference; (b) Type of study, number of original studies included, and number of subjects; (c) Objectives of the review; (d) Description of the population; (e) Description of the intervention and comparison group within the review; (f) Number of original studies included in meta-analysis per each outcome measure; (g) Outcome measures; and (h) Main results. Data extraction was performed by the author (AP) and checked for accuracy by a second reviewer (KD).

### **2.6 Data synthesis and analysis**

The meta-analyses were performed using Comprehensive Meta-analysis software (version 3.0). For all reported outcome measures, the standardized mean difference (SMD) along with 95% CIs were calculated. If at least two included studies reported the same outcome and were considered homogenous, then a meta-analysis was conducted and presented with a forest plot. Due to differences in outcomes assessed and measurement scales used between studies, general physical function assessments, self-reported physical function tests and evaluation of the pain intensity were treated separately. Therefore, composite ES (cES) and 95% CI were calculated for each study to overcome the problem of dependence from multiple outcomes and pre-post evaluation periods [16]. A random-effects model of the meta-analysis was used in all comparisons. However, to assess the sensitivity of each meta-analysis conducted, along with random effect, the fixed effect of the meta-analyses was presented. In addition, the publication bias was assessed by examining the asymmetry of the funnel plots using Egger's test, whereas a significant publication bias was considered if the p value was <0.10. The magnitude of the MI practice effects on outcome measures of interest was interpreted as changes using the following criteria: *trivial* (<0.20), *small* (0.21–0.60), *moderate* (0.61–1.20), *large* (1.21–2.00), *very large* (2.01–4.00) and *extremely large* (>4.00) [17]. The I2 statistic was used to investigate between-study heterogeneity; where values of 25, 50, and 75% represent *low, moderate* and *high* statistical heterogeneity, respectively [18]. Statistical significance for all tests performed was set at the level of p ≤ 0.05 [17].
