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Yap BWD, Lim ECW The Effects of Motor Imagery on Pain and Range of Motion in Musculoskeletal Disorders: A Systematic Review Using Meta-Analysis. Clin J Pain. 2019 Jan;35(1):87-99. doi: 10.1097/AJP.0000000000000648. (Systematic review)
Abstract

INTRODUCTION: In recent years, there has been an increase in the use of motor imagery (MI) in the rehabilitation of musculoskeletal pain conditions. Across the literature, most reviews have yet to consider Laterality Judgement Task training as a form of MI method. This review aimed to evaluate the effectiveness of using MI as an adjunct to standard rehabilitation on the improvement of pain and range of motion parameters when managing patients with musculoskeletal pain conditions.

METHODS: Searches of 8 major electronic databases were conducted. Data for pain and range of motion were extracted. Meta-analyses (where possible) with either a fixed or random-effect(s) model, standardized mean differences (SMDs), and tests of heterogeneity were performed.

RESULTS: Eight clinical controlled trials were identified and included in the meta-analyses. When compared with standard rehabilitation alone, the adjunctive role of MI provided superior pain relief (pooled SMD, -2.25; 95% confidence interval, -4.11 to -0.4; P=0.02), and greater improvement in range of motion (pooled SMD, 3.04; 95% confidence interval, 0.66-5.43; P=0.01) in chronic musculoskeletal pain disorders.

DISCUSSION: The results suggest that MI may be effective for pain relief and improvement in range of motion among chronic musculoskeletal pain conditions, although conclusion is based on a limited certainty of evidence as assessed using the GRADES (Grading of Recommendation, Assessment, Development and Evaluation) approach.

Ratings
Discipline Area Score
Rehab Clinician (OT/PT) 6 / 7
Physician 5 / 7
Comments from MORE raters

Rehab Clinician (OT/PT) rater

The study provides useful evidence that MI has a role in rehabilitation with this client group though the conclusion cited in the article needs to be viewed for the strength of evidence. 'Although based on the limited certainty of evidence, the findings from this review provide preliminary support that adjunctive MI is superior to standard rehabilitation alone for pain relief and improvement in range of motion in chronic musculoskeletal pain disorder. Future studies, using larger samples and with assessor blinding, are warranted to draw a more conclusive note on the effects of MI on pain and range of motion in musculoskeletal pain disorders'.
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