The efficacy of movement representation techniques for treating limb pain – a systematic review and metaanalysis

Relatively new evidence suggests that movement representation techniques, i.e. therapies that use the observation and/or imagination of normal pain-free movements, such as Mirror Therapy, Motor Imagery or Movement/ Action Observation may be effective in reducing some types of limb pain. To summarize the evidence regarding the efficacy of those techniques, a systematic review with metaanalysis was performed. We searched CENTRAL, MEDLINE, EMBASE, CINAHL, AMED, PsychINFO, PEDro and OT-seeker up to August 2014 and handsearched further relevant resources for randomised controlled trials that studied the efficacy of movement representation techniques in reducing limb pain. The outcomes of interest were pain, disability, and quality of life. Study selection and data extraction were performed by 2 reviewers independently. We included 15 trials on the effects of Mirror Therapy, (Graded) Motor Imagery, and Action Observation in patients with Complex Regional Pain Syndrome, Phantom Limb Pain, post-stroke pain, and non-pathological (acute) pain. Overall, movement representation techniques were found to be effective in reducing pain (SMD=-0.82, 95%CI [-1.32…-0.31] p=0.001) and disability (SMD=0.72, 95%CI [0.22…1.22], p=0.004) and showed a positive but non-significant effect on quality of life (SMD=2.61, 85%CI [-3.32…8.54], p=0.39). Especially Mirror Therapy and Graded Motor Imagery should be considered for the treatment of patients with Complex Regional Pain Syndrome.

Furthermore, the results indicate that Motor Imagery could be considered as a potential effective treatment in patients with acute pain after trauma and surgery. To date, there is no evidence for a pain reducing effects of movement representation techniques in patients with Phantom Limb Pain and Post Stroke Pain other than Complex Regional Pain Syndrome.

Neck Pain

Out of all 291 conditions studied in the Global Burden of Disease 2010 Study, neck pain ranked 4th highest in terms of disability and 21st in terms of overall burden.

Comments

Dr. Ramesh Avadhani
Dr. Ramesh Avadhani
December 2, 2015 at 6:13 am

This movement therapy is really useful in pain management, which is an old WINDOW IN A NEW GLASS. As a Physician in rehab medicine, we advise our post amputee patients with phantom pain and phantum sensation to this kind of imaginary movement therapy….we call it….to EXERCISE THE PHANTOM. AS ONE OF causes of this pain, it is well established that the mind doesnt accept the loss of a limb, which has been a part of human being for years and to treat the pain we advise to exercise the phantom. And new movement therapy is similar to that. Especially when the amputees are advised to imagine as if the discarded limb is still there and she or he will exercise that phantom limb.
Anyway i appreciate this therapy very much.

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