Abstract
Graded motor imagery (GMI) is becoming increasingly used in the treatment of chronic
pain conditions. The objective of this systematic review was to synthesize all evidence
concerning the effects of GMI and its constituent components on chronic pain. Systematic
searches were conducted in 10 electronic databases. All randomized controlled trials
(RCTs) of GMI, left/right judgment training, motor imagery, and mirror therapy used
as a treatment for chronic pain were included. Methodological quality was assessed
using the Cochrane risk of bias tool. Six RCTs met our inclusion criteria, and the
methodological quality was generally low. No effect was seen for left/right judgment
training, and conflicting results were found for motor imagery used as stand-alone
techniques, but positive effects were observed for both mirror therapy and GMI. A
meta-analysis of GMI versus usual physiotherapy care favored GMI in reducing pain
(2 studies, n = 63; effect size, 1.06 [95% confidence interval, .41, 1.71]; heterogeneity,
I2 = 15%). Our results suggest that GMI and mirror therapy alone may be effective, although
this conclusion is based on limited evidence. Further rigorous studies are needed
to investigate the effects of GMI and its components on a wider chronic pain population.
Perspective
This systematic review synthesizes the evidence for GMI and its constituent components
on chronic pain. This review may assist clinicians in making evidence-based decisions
on managing patients with chronic pain conditions.
Key words
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Article info
Publication history
Published online: November 19, 2012
Footnotes
G.L.M. is supported by an NHMRC Senior Research Fellowship. T.R.S. is supported by the Canadian Institutes of Health Research Postdoctoral Training Fellowship [ID 223354]. This work supported by NHMRC project grant ID 1008017.
The authors have no conflicts of interest to report.
Supplementary data related to this article can be found at http://dx.doi.org/10.1016/j.jpain.2012.09.007.
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© 2013 American Pain Society. Published by Elsevier Inc. All rights reserved.
