The effects of graded motor imagery and its components on chronic pain: a systematic review and meta-analysis.
Graded motor imagery (GMI) is becoming increasingly used in the treatment of chronic pain conditions. The objective of this systematic review was to synthesise 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 and six RCTs met the predefined 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 favoured GMI in reducing pain. The results therefore 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. > From: Bowering et al., J Pain 14 (2013) 3-13. All rights reserved to the American Pain Society.
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