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Stonsaovapak C, Koonalinthip N, Kitisomprayoonkul W. Efficacy of mirror neuron system-based therapy for rehabilitation of upper limb orthopedic conditions: A systematic review and meta-analysis. PM R 2024. [PMID: 39051506 DOI: 10.1002/pmrj.13239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 05/05/2024] [Accepted: 05/16/2024] [Indexed: 07/27/2024]
Abstract
OBJECTIVE The aim of this systematic review and meta-analysis is to assess the efficacy of mirror neuron system-based therapy for managing pain and improving motor and upper limb function in patients with upper limb orthopedic conditions. LITERATURE SURVEY Systematic bibliographical searches of the PubMed, SCOPUS, and CENTRAL registries and databases up to September 2023 were conducted to find randomized controlled trials (RCTs) assessing the efficacy of mirror neuron system-based therapy for rehabilitation of upper limb orthopedic conditions. METHODOLOGY Two reviewers assessed the RCTs using a Cochrane risk-of-bias tool and extracted data from studies with similar outcome measures in the domains of pain, motor function, or functional score, which were pooled into meta-analyses. SYNTHESIS The review included 13 studies to compare the efficacy of mirror neuron system-based therapy with that of conventional rehabilitation programs. The therapy reduced pain intensity (mean difference [MD] 2.04, 95% confidence interval [CI] 1.46-2.63) and kinesiophobia (MD 8.43, 95% CI 6.98 to 9.88), and increased grip strength (MD 1.86, 95% CI 0.28-3.45). The therapy also improved upper limb functional outcomes as assessed by the 30-item Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire score (MD 13.52, 95% CI 10.63-16.41). However, the outcomes as assessed by the 11-item QuickDASH questionnaire and the Shoulder Pain and Disability Index (SPADI) were not superior to conventional rehabilitation. CONCLUSIONS Mirror neuron system-based therapy for rehabilitation of upper limb orthopedic conditions may reduce pain intensity and kinesophobia, and improve grip strength and DASH scores compared with conventional rehabilitation programs. However, this interpretation is limited by the heterogeneity and various quality of the RCTs included in our meta-analysis.
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Affiliation(s)
- Chernkhuan Stonsaovapak
- Department of Rehabilitation Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Nantawan Koonalinthip
- Department of Rehabilitation Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Wasuwat Kitisomprayoonkul
- Department of Rehabilitation Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Samadi M, Malmir K. Effects of mental practice on pain, functionality, and quality of life in individuals with chronic neck pain: A systematic review. Complement Ther Clin Pract 2023; 50:101690. [PMID: 36375324 DOI: 10.1016/j.ctcp.2022.101690] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/20/2022] [Accepted: 11/06/2022] [Indexed: 11/11/2022]
Abstract
PURPOSE There are conflicting reports in the literature regarding the effectiveness of motor imagery (MI) and action observation (AO) in individuals with chronic non-specific neck pain (CNSNP). This study sought to systematically investigate whether mental practice has any impact on pain, functionality and quality-of-life in individuals with CNSNP. METHODS This is a systematic review. Randomized controlled trials (RCTs) that explored the effects of mental practice on pain, functionality and quality-of-life in individuals with CNSNP were searched using databases PubMed, Cochrane library, Medline via Ovid, Scopus, and PEDro from inception to July 2022. Two reviewers independently extracted data and evaluated the quality of the studies utilizing the PEDro scale. RESULTS Six high-quality RCTs with 128 participants with CNSNP in the MI and AO groups, and 93 participants with CNSNP in the control group, were included in this review. Both AO and MI were effective in improving pain response and cervical joint position sense. However, AO was more efficient than MI and its effects were retained longer. Improvements in the visual analogue scale and neck disability index were retained when MI training lasted for 6 weeks. The pain and general health sub-parameters of the short form-36 health survey improved after MI training. CONCLUSION Mental practice, particularly AO, can improve neck pain intensity, joint position sense, functional disability, and some aspects of quality-of-life in individuals with CNSNP. These improvements dissipated over time. Although mental practice can be an alternative to exercise when pain exists, it can be more efficient when prescribed with simple movements and exercises. REGISTRATION The protocol of this review was registered with PROSPERO (CRD42022330240) Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022330240.
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Affiliation(s)
- Mansoureh Samadi
- Physical Therapy Department, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
| | - Kazem Malmir
- Physical Therapy Department, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
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Monsma EV, Gregg MJ, Seiler B, Sacko RS, Hall CR. Convergent validity and sex invariant factor structure of the Movement Imagery Questionnaire-3 - Second version (MIQ-3S): Healthy, young adult reference data. Musculoskelet Sci Pract 2022; 59:102537. [PMID: 35219223 DOI: 10.1016/j.msksp.2022.102537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 02/01/2022] [Accepted: 02/19/2022] [Indexed: 11/17/2022]
Abstract
Aligned with the approach that established the factor structure of the Movement Imagery Questionnaire-3 (MIQ-3), this study extended the two-factor structure of the Movement Imagery Questionnaire - Revised Second version (MIQ-RS). The extension involves assessment of both internal and external visual imagery abilities along with kinesthetic imagery ability. Participants (N = 396) completed the new Movement Imagery Questionnaire - 3 Second Version (MIQ-3S) along with the Vividness of Movement Imagery Questionnaire-2 (VMIQ-2) which measure the same three imagery abilities. Alpha coefficients and between scale Spearman correlations for internal, external, and kinesthetic abilities indicated items were internally consistent (α > 0.87) and established convergent validity (r > 0.69), respectively. MIQ-3S scale means ranged from 5.56 (SD = 1.10) to 5.98 (SD = 0.84), with no differences by sex. The three scales were not multicolinear as intra-scale correlations ranged from 0.47 to 0.61, supporting the three abilities were related, but separate constructs. A multi-trait multimethod confirmatory factor analysis (MTMM CFA), with sex invariance, was conducted to confirm the 3-factor structure of the MIQ-3S. Results from 396 healthy male (n = 200) and female (n = 196) adult college-aged students (M = 21.91, SD = 2.37) indicated a correlated-traits correlated-uniqueness model provided the best fit to the data (CFI = 0.99; SRMR = 0.05; RMSEA = 0.03), while displaying sex invariance. These findings provide baseline data on college-aged, healthy adult participants providing reference data to those investigating imagery abilities among injured populations and practitioners interested in tracking individuals in rehabilitation.
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Cuenca-Martínez F, Angulo-Díaz-Parreño S, Feijóo-Rubio X, Fernández-Solís MM, León-Hernández JV, LA Touche R, Suso-Martí L. Motor effects of movement representation techniques and cross-education: a systematic review and meta-analysis. Eur J Phys Rehabil Med 2022; 58:94-107. [PMID: 34105921 PMCID: PMC9987463 DOI: 10.23736/s1973-9087.21.06893-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION The objective was to assess the impact of movement representation techniques (MRT) through motor imagery (MI), action observation (AO) and visual mirror feedback (VMF) and cross-education training (CE) on strength, range of motion (ROM), speed, functional state and balance during experimental immobilization processes in healthy individuals, in patients with injuries that did not require surgery and in those with surgical processes that did or did not require immobilization. EVIDENCE ACQUISITION MEDLINE, EMBASE, CINAHL and Google Scholar were searched. Thirteen meta-analyses were conducted. EVIDENCE SYNTHESIS Regarding the immobilized participants, in the healthy individuals, MI showed significant results regarding maintenance of strength and ROM, with low-quality evidence. Regarding the process with no immobilization, VMF and MI techniques showed significant changes in maintaining ROM in patients with injury without surgery, with very low-quality evidence. Results had shown that MI demonstrated significantly higher maintenance of strength and speed in patients undergoing surgery, with low-quality evidence. No significant results were found in ROM. Low-quality evidence showed better results in AO plus usual care compared with usual treatment in isolation with respect to maintenance of functional state and balance. CE training demonstrated maintenance of strength in patients undergoing surgery, with moderate evidence; however, not in healthy experimentally immobilized individuals. VMF did not show significant results in maintaining ROM after surgery without immobilization, nor did MI in maintaining strength after surgery and immobilization. CONCLUSIONS MRT and CE training have been shown to have a significant impact on the improvement of various motor variables and on physical maintenance in general.
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Affiliation(s)
- Ferran Cuenca-Martínez
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), La Salle Higher Center for University Studies, Autonomous University of Madrid, Madrid, Spain
| | - Santiago Angulo-Díaz-Parreño
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), La Salle Higher Center for University Studies, Autonomous University of Madrid, Madrid, Spain.,Faculty of Medicine, CEU San Pablo University, Madrid, Spain
| | - Xosé Feijóo-Rubio
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Marta M Fernández-Solís
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - José V León-Hernández
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), La Salle Higher Center for University Studies, Autonomous University of Madrid, Madrid, Spain
| | - Roy LA Touche
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain - .,Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), La Salle Higher Center for University Studies, Autonomous University of Madrid, Madrid, Spain.,Institute of Neurosciences and Craniofacial Pain (INDCRAN), Madrid, Spain
| | - Luis Suso-Martí
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), La Salle Higher Center for University Studies, Autonomous University of Madrid, Madrid, Spain.,Department of Physiotherapy, CEU Cardenal Herrera University, CEU Universities, Valencia, Spain
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Varangot-Reille C, Cuenca-Martínez F, Suso-Martí L, La Touche R, Rouquette A, Hamon J, Araldi M, de Asís-Fernández F, Herranz-Gómez A. Hypoalgesic effects of a blood flow restriction technique at moderate intensity with or without motor imagery: a single-blind randomized controlled trial. Somatosens Mot Res 2021; 39:29-38. [PMID: 34645366 DOI: 10.1080/08990220.2021.1987876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE The main objective was to assess the hypoalgesic effect of adding blood flow restriction (BFR) training with or without motor imagery (MI) to moderate-intensity exercise. The secondary objective was to analyse the correlations of the pain pressure thresholds (PPTs) regarding perceived pain intensity, perceived fatigue, and cuff pressure discomfort. METHODS A sample of 42 asymptomatic participants were randomly assigned to 3 groups: control group (CG), BFR group, and BFR with MI group. All participants performed a squat exercise at an intensity of 60% of 1RM. For the BFR groups, blood occlusion occurred at 80% of maximal arterial occlusive pressure. Local, bilateral, and distal PPT were assessed pre-intervention, post-intervention and 48 h post-intervention. The perceived fatigue was assessed post-intervention, and pain intensity was assessed only 48 h post-intervention. RESULTS There were intragroup differences in the CG and BFR + MI group in the local PPT between the pre-intervention and post-intervention measurements (p = 0.039, d= -0.32 and p = 0.009, d= -0.46, respectively) and only in the CG in the bilateral PPT (p = 0.002, d= -0.41). The CG and BFR group showed significant differences at 48 h post-intervention, with a decrease in local PPT (p = 0.009, d = 0.51 and p = 0.049, d = 0.43, respectively) and bilateral PPT (p = 0.004, d = 0.53 and p = 0.021, d = 0.46, respectively). There was a negative moderate correlation between local PPT at the post-intervention time and perceived discomfort of the occlusion device only in the BFR group (r=-0.54, p = 0.045). CONCLUSION Moderate-intensity resistance training with high occlusion did not generate hypoalgesia but did appear to generate a hyperalgesic response within 48 h after the intervention.
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Affiliation(s)
- Clovis Varangot-Reille
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Ferran Cuenca-Martínez
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Luis Suso-Martí
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Department of Physiotherapy, Universidad CEU Cardenal Herrera, CEU Universities, Valencia, Spain
| | - Roy La Touche
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Instituto de Neurociencia y Dolor Craneofacial (INDCRAN), Madrid, Spain
| | - Amélie Rouquette
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Julie Hamon
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Maxime Araldi
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Francisco de Asís-Fernández
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Breatherapy Research Group, Instituto de Neurociencias y Ciencias del Movimiento (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Aida Herranz-Gómez
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
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Öztürk Ö, Bombacı H, Keçeci T, Algun ZC. Effects of additional action observation to an exercise program in patients with chronic pain due to knee osteoarthritis: A randomized-controlled trial. Musculoskelet Sci Pract 2021; 52:102334. [PMID: 33582621 DOI: 10.1016/j.msksp.2021.102334] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 12/30/2020] [Accepted: 01/20/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Knee osteoarthritis (OA) leads to pain, stiffness, and functional impairment and eventually decreased level of the quality of life. Although several treatment methods have been used to achieve pain relief, patients still complain of pain. OBJECTIVE The aim of this study was to investigate the effects of the addition of action observation therapy to an exercise program on pain severity, pressure pain threshold, kinesiphobia functionality, and pain catastrophization in knee OA patients with chronic pain. METHODS This prospective, randomized-controlled, superiority trial included a total of 36 patients with knee OA. The patients were randomly divided into two groups as the treatment group (n = 18) receiving action observation therapy in addition to exercise and control group (n = 18) receiving exercise alone. The interventions were performed three times weekly for six weeks. The primary outcomes were pain and pressure pain threshold. Secondary outcomes were kinesiphobia, functionality, and pain catastrophization. All participants were assessed at baseline (pre-intervention) and after the six-week treatment (post-intervention). RESULTS There was no significant difference in the primary and secondary outcome measures before and after the intervention between the groups (p > 0.05). Both groups showed a significant improvement in all outcome measures after the intervention (p < 0.01). CONCLUSION Our study results suggest that action observation therapy in addition to an exercise program does not contribute any additional benefits to pain, pressure pain threshold, kinesiophobia, pain catastrophization, and functionality in knee OA patients with chronic pain. Nonetheless, further large-scale, long-term, prospective studies are needed to gain a better understanding on this subject.
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Affiliation(s)
- Özgül Öztürk
- Acibadem Mehmet Ali Aydinlar University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey.
| | - Hasan Bombacı
- University of Health Sciences, Haydarpaşa Numune Research and Training Hospital, Department of Orthopedics and Traumatology, Istanbul, Turkey
| | - Tolga Keçeci
- Ordu University, Faculty of Medicine, Department of Orthopedics and Traumatology, Ordu, Turkey
| | - Zeliha Candan Algun
- Istanbul Medipol University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey
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Amundsen O, Starcevich C, Frisell EJ, Nordal T, Williams S, Mitchell T, Beales D. Does body scanning through visual imagery improve perception and function in patients after anterior cruciate ligament-reconstruction? An exploratory study. Physiother Theory Pract 2021; 38:1996-2006. [PMID: 33726630 DOI: 10.1080/09593985.2021.1901328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introduction: Many people who have undergone Anterior Cruciate Ligament (ACL)-reconstruction do not return to their pre-injury level, with nonphysical factors recognized as barriers to recovery. Fear of movement has been linked to body schema distortions, and interventions directed at the body schema have shown potential to improve function.Objective: 1) Describe participants' ability to perform a visual imagery intervention (Body Scan); 2) investigate knee perception differences; 3) investigate if Body Scan led to improvements in perceptual differences; and 4) determine if some individuals improved in functional measures following the intervention.Methods: A single-arm intervention study was undertaken in people >12-month post ACL-reconstruction (n = 30). Body Scan was delivered using a standardized script developed for this study. Participants were assessed regarding their capacity to perform the Body Scan, perceptual differences between the knees and how perception changed following the intervention. Functional measures (vertical hop, triple hop, mSEBT, quadriceps strength, and hamstring strength) were taken.Results: 96.7% were able to perform a Body Scan, with 93.1% demonstrating a difference in perception between the knees. Of participants with perceptual differences, 92.5% demonstrated improvement in perception following the intervention. Ten participants had a clinically significant improvement in a functional measure following the intervention.Conclusion: Most participants could perform Body Scanning. The majority perceived perceptual differences between operated and non-operated knees, and reported more symmetric perception following the intervention. One-third of participants also showed improvements in a functional performance measure. Results suggest this intervention may be a helpful adjunct to rehabilitation post ACL-reconstruction, with further research warranted.
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Affiliation(s)
- Olav Amundsen
- School of Physiotherapy and Exercise Science, Curtin University, Bentley, Australia
| | - Cobie Starcevich
- School of Physiotherapy and Exercise Science, Curtin University, Bentley, Australia
| | | | - Tom Nordal
- School of Physiotherapy and Exercise Science, Curtin University, Bentley, Australia
| | - Sian Williams
- School of Physiotherapy and Exercise Science, Curtin University, Bentley, Australia
| | - Tim Mitchell
- School of Physiotherapy and Exercise Science, Curtin University, Bentley, Australia
| | - Darren Beales
- School of Physiotherapy and Exercise Science, Curtin University, Bentley, Australia
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Goble MSL, Raison N, Mekhaimar A, Dasgupta P, Ahmed K. Adapting Motor Imagery Training Protocols to Surgical Education: A Systematic Review and Meta-Analysis. Surg Innov 2021; 28:329-351. [PMID: 33710912 PMCID: PMC8264649 DOI: 10.1177/1553350621990480] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective. Motor imagery (MI) is widely used to improve technical skills in sports and has been proven to be effective in neurorehabilitation and surgical education. This review aims to identify the key characteristics of MI protocols for implementation into surgical curricula. Design. This study is a systematic review and meta-analysis. PubMed, MEDLINE, Embase and PsycINFO databases were systematically searched. The primary outcome was the impact of MI training on measured outcomes, and secondary outcomes were study population, MI intervention characteristics, study primary outcome measure and subject rating of MI ability (systematic review registration: PROSPERO CRD42019121895). Results. 456 records were screened, 60 full texts randomising 2251 participants were reviewed and 39 studies were included in meta-analysis. MI was associated with improved outcome in 35/60 studies, and pooled analysis also showed improved outcome on all studies with a standardised mean difference of .39 (95% CI: .12, .67, P = .005). In studies where MI groups showed improved outcomes, the median duration of training was 24 days (mode 42 days), and the median duration of each individual MI session was 30 minutes (range <1 minute-120 minutes). Conclusions. MI training protocols for use in surgical education could have the following characteristics: MI training delivered in parallel to existing surgical training, in a flexible format; inclusion of a brief period of relaxation, followed by several sets of repetitions of MI and a refocusing period. This is a step towards the development of a surgical MI training programme, as a low-cost, low-risk tool to enhance practical skills.
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Affiliation(s)
- Mary S L Goble
- MRC Centre for Transplantation, Guy's Hospital, 4616King's College London, UK
| | - Nicholas Raison
- MRC Centre for Transplantation, Guy's Hospital, 4616King's College London, UK
| | - Ayah Mekhaimar
- MRC Centre for Transplantation, Guy's Hospital, 4616King's College London, UK
| | - Prokar Dasgupta
- MRC Centre for Transplantation, Guy's Hospital, 4616King's College London, UK.,Department of Urology, 4616Guy's and St Thomas' NHS Foundation Trust, King's Health Partners, London, UK
| | - Kamran Ahmed
- MRC Centre for Transplantation, Guy's Hospital, 4616King's College London, UK.,Department of Urology, 4616Guy's and St Thomas' NHS Foundation Trust, King's Health Partners, London, UK
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Briones-Cantero M, Fernández-de-Las-Peñas C, Lluch-Girbés E, Osuna-Pérez MC, Navarro-Santana MJ, Plaza-Manzano G, Martín-Casas P. Effects of Adding Motor Imagery to Early Physical Therapy in Patients with Knee Osteoarthritis who Had Received Total Knee Arthroplasty: A Randomized Clinical Trial. PAIN MEDICINE 2020; 21:3548-3555. [PMID: 32346743 DOI: 10.1093/pm/pnaa103] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To investigate the effects of the inclusion of motor imagery (MI) principles into early physical therapy on pain, disability, pressure pain thresholds (PPTs), and range of motion in the early postsurgical phase after total knee arthroplasty (TKA). METHODS A randomized clinical trial including patients with knee osteoarthritis who have received TKA was conducted. Participants were randomized to receive five treatment sessions of either physical therapy with or without MI principles in an early postsurgical phase after a TKA (five days after surgery). Pain intensity (visual analog scale [VAS], 0-100), pain-related disability (short-form Western Ontario McMaster Universities Osteoarthritis Index [WOMAC], 0-32), pressure pain thresholds (PPTs), and knee range of motion were assessed before and after five daily treatment sessions by an assessor blinded to the subject's condition. RESULTS Twenty-four participants completed data collection and treatment. The adjusted analysis revealed significant group*time interactions for WOMAC (F = 17.29, P = 0.001, η2 = 0.48) and VAS (F = 14.56, P < 0.001, η2 = 0.45); patients receiving physiotherapy and MI principles experienced greater improvements in pain (Δ -28.0, 95% confidence interval [CI] = -43.0 to -13.0) and pain-related disability (Δ -6.0, 95% CI = -8.3 to -3.7) than those receiving physiotherapy alone. No significant group*time interactions for knee range of motion and PPTs were observed (all, P > 0.30). CONCLUSIONS The application of MI to early physiotherapy was effective for improving pain and disability, but not range of motion or pressure pain sensitivity, in the early postsurgical phase after TKA in people with knee osteoarthritis.
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Affiliation(s)
- María Briones-Cantero
- Unidad de Fisioterapia, Servicio de Rehabilitación, Hospital Universitario Doce de Octubre, Madrid, Spain
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.,Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca, y Ejercicio Terapéutico, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Enrique Lluch-Girbés
- Department of Physical Therapy, Universidad de Valencia, Valencia, Spain; Pain in Motion Research Group.,Department of Human Physiology (Chropiver), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel
| | | | | | - Gustavo Plaza-Manzano
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, Madrid, Spain
| | - Patricia Martín-Casas
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, Madrid, Spain.,Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain
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Javdaneh N, Molayei F, Kamranifraz N. Effect of adding motor imagery training to neck stabilization exercises on pain, disability and kinesiophobia in patients with chronic neck pain. Complement Ther Clin Pract 2020; 42:101263. [PMID: 33276225 DOI: 10.1016/j.ctcp.2020.101263] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 10/26/2020] [Accepted: 11/13/2020] [Indexed: 12/17/2022]
Abstract
PURPOSE The investigation of this study was to compare the effect of adding motor imagery training to neck stabilization exercises on pain, disability, and kinesiophobia in patients with chronic neck pain. MATERIAL AND METHODS After screening, seventy-two volunteers with chronic neck pain were randomly allocated to 3 groups: neck stabilization exercises alone, n = 24, combined ( neck stabilization exercises + motor imagery training), n = 24, and a control group, n = 24. Pain intensity, disability, and kinesiophobia before and after the intervention exercises were measured by the Visual Analog Scale, Neck Disability Index, and the Tampa Scale of Kinesiophobia , respectively. RESULTS Statistically significant differences in pain intensity, the neck disability index, and kinesiophobia were found when a combined intervention group including neck stabilization and motor imagery training was compared with neck stabilization training alone at 6 weeks ) p ≤ 0.005). Also, there were significant between-group differences favoring experimental groups versus control for all outcomes (p ≤ 0.001). CONCLUSION neck stabilization exercises in combination with motor imagery training was superior to neck stabilization exercises alone in decreasing pain, disability, and kinesiophobia in patients with chronic neck pain.
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Affiliation(s)
- Norollah Javdaneh
- Department of Biomechanics and Sport Medicine, Kharazmi University, Tehran, Iran.
| | - Feridon Molayei
- Iran University of Medical Sciences & Physiotherapy Center of Ahangesalamati, Tehran, Iran
| | - Nazanin Kamranifraz
- Iran University of Medical Sciences & Physiotherapy Center of Ahangesalamati, Tehran, Iran
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Zisa NS, Rubio C, Gómez M. [Reliability and validity of the mental evocation of images, movements and activities questionnaire: a pilot study]. Rehabilitacion (Madr) 2020; 55:258-265. [PMID: 33143944 DOI: 10.1016/j.rh.2020.09.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 09/04/2020] [Accepted: 09/12/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION AND OBJECTIVES Motor imaging is a widely used technique in neurological rehabilitation. Its utility and results are influenced by the ability to imagine a movement, which can be evaluated by various instruments. This study aimed to assess the psychometric properties of a recently-designed instrument for assessment of the hand and arm: the Mental Evocation of Images, Movements and Activities Questionnaire. MATERIALS AND METHODS We assessed 29 patients (41% men and 59% women) with a mean age of 45 years. At a first visit, all were administered the Mental Evocation of Images, Movements and Activities Questionnaire and the Spanish version of the Movement Imagery Questionnaire-Revised. At a second visit, the patients underwent a retest of the Mental Evocation of Images, Movements and Activities Questionnaire. We calculated descriptive statistics, internal consistency, test-retest reliability, reproducibility and concurrent validity between the two instruments. RESULTS Reliability/internal consistency: we found good indexes of internal consistency both for the global scale and for its two subscales: evocation and sensation. Reliability/test-retest: we found no significant differences in a 1-week interval. Reproducibility: we found an excellent intraclass correlation coefficient. Concurrent validity: the Mental Evocation of Images, Movements and Activities Questionnaire showed a strong correlation with the Movement Imagery Questionnaire-Revised. CONCLUSIONS The Mental Evocation of Images, Movements and Activities Questionnaire is a psychometrically robust instrument that can be used to measure the ability to form visual and kinesthetic mental images of the hand/arm. The instrument also provides information on the imaging process in the person under evaluation.
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Affiliation(s)
- N S Zisa
- Centro Logros Terapia Infantil, Majadahonda, Madrid, España
| | - C Rubio
- Departamento de Ciencias de la Ocupación, Logopedia, Psicología Evolutiva y de la Educación, Facultad de Psicología, Universidad Católica de Valencia San Vicente Mártir, Valencia, España.
| | - M Gómez
- Instituto de Rehabilitación Funcional La Salle, Madrid, España
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12
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Paravlic AH, Maffulli N, Kovač S, Pisot R. Home-based motor imagery intervention improves functional performance following total knee arthroplasty in the short term: a randomized controlled trial. J Orthop Surg Res 2020; 15:451. [PMID: 33008432 PMCID: PMC7531130 DOI: 10.1186/s13018-020-01964-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 09/14/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Motor imagery (MI) is effective in improving motor performance in the healthy asymptomatic adult population. However, its possible effects among older orthopaedic patients are still poorly investigated. Therefore, this study explored whether the addition of motor imagery to routine physical therapy reduces the deterioration of quadriceps muscle strength and voluntary activation (VA) as well as other variables related to motor performance in patients after total knee arthroplasty (TKA). METHODS Twenty-six patients scheduled for TKA were randomized to either MI practice combined with routine physical therapy group (MIp) or to a control group receiving physical therapy alone (CON). MIp consisted of maximal voluntary isometric contraction (MViC) task: 15 min/day in the hospital, then 5 times/week in their homes for 4 weeks. MViC and VA of quadriceps muscle, knee flexion and extension range of motion, pain level, along with a Timed Up-and-Go Test (TUG) and self-reported measure of physical function (assessed using the Oxford Knee Score questionnaire [OKS]) were evaluated before (PRE) and 1 month after surgery (POST). RESULTS Significantly better rehabilitation outcomes were evident on the operated leg for the MIp group compared to CON: at POST, the MIp showed lower strength decrease (p = 0.012, η2 = 0.237) and unaltered VA, significantly greater than CON (p = 0.014, η2 = 0.227). There were no significant differences in knee flexion and extension range of motion and pain level (p > 0.05). Further, MIp patients performed better in TUG (p < 0.001, η2 = 0.471) and reported better OKS scores (p = 0.005, η2 = 0.280). The non-operated leg showed no significant differences in any outcomes at POST (all p > 0.05). In addition, multiple linear regression analysis showed that failure of voluntary activation explained 47% of the quadriceps muscle strength loss, with no significant difference in perceived level of pain. CONCLUSION MI practice, when added to physical therapy, improves both objective and subjective measures of patients' physical function after TKA, and facilitates transfer of MI strength task on functional mobility. TRIAL REGISTRATION Retrospectively registered on ClinicalTrials.gov NCT03684148.
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Affiliation(s)
- Armin H Paravlic
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia
| | - Nicola Maffulli
- Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Salerno, Italy.
- Centre for Sports and Exercise Medicine, Queen Mary University of London, London, UK.
- School of Pharmacy and Bioengineering, Keele University School of Medicine, Stoke on Trent, UK.
| | - Simon Kovač
- Orthopaedic Hospital Valdoltra, Ankaran, Slovenia
| | - Rado Pisot
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
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13
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Araya-Quintanilla F, Gutiérrez-Espinoza H, Jesús Muñoz-Yanez M, Rubio-Oyarzún D, Cavero-Redondo I, Martínez-Vizcaino V, Álvarez-Bueno C. The Short-term Effect of Graded Motor Imagery on the Affective Components of Pain in Subjects with Chronic Shoulder Pain Syndrome: Open-Label Single-Arm Prospective Study. PAIN MEDICINE 2020; 21:2496-2501. [PMID: 32003812 DOI: 10.1093/pm/pnz364] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To determine the short-term effect of graded motor imagery (GMI) on the affective components of pain and range of motion in subjects with chronic shoulder pain syndrome. DESIGN Open-label single-arm prospective study. SETTING The Physical Therapy Laboratory, Universidad de las Americas. SUBJECTS One hundred seven patients with chronic shoulder pain syndrome. METHODS The subjects received a six-week GMI program based on laterality training, imagined movements, and mirror therapy. We assessed pain intensity using a visual analog scale (VAS), fear of movement was assessed using the Tampa Scale of Kinesiophobia (TSK), and catastrophizing was assessed using the Pain Catastrophizing Scale (PCS). The patient's flexion active range of motion (AROM) was also recorded. RESULTS At the end of treatment, the VAS showed a decrease of 4.2 cm (P < 0.001, Cohen's d = 3.3), TSK showed a decrease of 17.0 points (P < 0.001, Cohen's d = 2.8), catastrophizing showed a decrease of 19.2 points (P < 0.001, Cohen's d = 3.2), and shoulder flexion AROM showed an increment of 30.3º (P < 0.000, Cohen's d = 1.6). CONCLUSIONS We conclude that a short-term GMI program improves the affective components of pain and shoulder flexion AROM in patients with chronic shoulder pain syndrome.
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Affiliation(s)
- Felipe Araya-Quintanilla
- Rehabilitation and Health Research Center CIRES, Universidad de Las Americas, Santiago, Chile.,Faculty of Health Sciences, Universidad SEK, Santiago, Chile
| | - Héctor Gutiérrez-Espinoza
- Rehabilitation and Health Research Center CIRES, Universidad de Las Americas, Santiago, Chile.,Physical Therapy Department, Clinical Hospital San Borja Arriaran, Santiago, Chile
| | - María Jesús Muñoz-Yanez
- Rehabilitation and Health Research Center CIRES, Universidad de Las Americas, Santiago, Chile
| | - David Rubio-Oyarzún
- Rehabilitation and Health Research Center CIRES, Universidad de Las Americas, Santiago, Chile
| | - Iván Cavero-Redondo
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain.,Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay
| | - Vicente Martínez-Vizcaino
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain.,Faculty of Health Sciences, Universidad Autonoma de Chile, Talca, Chile
| | - Celia Álvarez-Bueno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain.,Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay
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14
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Seven Key Themes in Physical Therapy Advice for Patients Living With Subacromial Shoulder Pain: A Scoping Review. J Orthop Sports Phys Ther 2020; 50:285-a12. [PMID: 32476583 DOI: 10.2519/jospt.2020.9152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To systematically scope the reported advice and education in physical therapy management of patients with subacromial shoulder pain, and to define key themes of the advice and education. DESIGN Scoping review. LITERATURE SEARCH We searched MEDLINE, Scopus, Web of Science, and CINAHL, with publication dates from 2007 to September 2019. STUDY SELECTION CRITERIA We included quantitative and qualitative research that reported on physical therapy interventions for subacromial shoulder pain. DATA SYNTHESIS We performed a qualitative synthesis that identified items included in patient advice and education. RESULTS Of 89 original studies included, there were 61 randomized controlled trials; 5 prospective studies; 16 nonrandomized observational intervention studies or case series; and 7 surveys, audits of physical therapy patient records, and focus groups with physical therapists. We identified 7 key themes for advice and education: exercise intensity and pain response, activity modification advice, posture advice, pain self-management advice, pathoanatomical and diagnosis information, behavioral approaches, and pain biology advice. CONCLUSION While advice focused predominantly on the local tissue pathology model, 10% of studies included information about pain neuroscience education, psychosocial factors, motor imagery, or behavior change. J Orthop Sports Phys Ther 2020;50(6):285-293. doi:10.2519/jospt.2020.9152.
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15
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Chen J, Kan W, Liu Y, Hu X, Wu T, Zou Y, Liu H, Yang K. Frequency-specific equivalence of brain activity on motor imagery during action observation and action execution. Int J Neurosci 2020; 131:599-608. [PMID: 32228346 DOI: 10.1080/00207454.2020.1750394] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Human motor imagery (MI), action execution, and action observation (AO) are functionally considered as equivalent. MI during AO can extensively induce activation of motor-related brain network in the absence of overt movement. The magnetoencephalography (MEG) provides an important technology to reveal and reflect human brain information processing in multi-frequency bands. Utilizing a MEG system, we aimed to quantitatively investigate the frequency-specific equivalent characteristics in brain processing patterns between MI during AO and action execution in multi-frequency bands, including delta, theta, alpha, beta, gamma, and high-frequency oscillations. METHODS A total of 12 healthy subjects were studied with a whole-head MEG system during finger movement and MI during finger movement observation. We analyzed the brain activities in multi-frequency ranges of 1 Hz to 200 Hz. RESULTS Both MI during AO and action execution evoked the distinctive brain activities in low frequency ranges (i.e. delta, theta, and alpha). Significant differences were found in global spectral power between finger movement and MI during AO in delta and alpha oscillations. Compared with finger movement, delta (1-4 Hz) oscillation power in MI during AO were obviously decreased in left and right frontals and occipitals, and theta (4-8 Hz) and alpha (8-13 Hz) oscillation power were obviously increased in frontal, parietal and occipital. CONCLUSION MEG power evoked by finger movement and MI during AO is mainly concentrated in the energy distribution below 13 Hz. Furthermore, finger movement and MI during AO might share frequency-specific equivalence of brain neural activation dependent on different MEG frequency ranges.
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Affiliation(s)
- Jiu Chen
- Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Fourth Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China.,Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Wenwu Kan
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yong Liu
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xinhua Hu
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Ting Wu
- MEG Center, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yuanjie Zou
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hongyi Liu
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Kun Yang
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
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Suso‐Martí L, La Touche R, Angulo‐Díaz‐Parreño S, Cuenca‐Martínez F. Effectiveness of motor imagery and action observation training on musculoskeletal pain intensity: A systematic review and meta‐analysis. Eur J Pain 2020; 24:886-901. [DOI: 10.1002/ejp.1540] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 01/26/2020] [Accepted: 02/05/2020] [Indexed: 11/08/2022]
Affiliation(s)
- Luis Suso‐Martí
- Motion in Brains Research Group Institute of Neuroscience and Sciences of the Movement (INCIMOV) Centro Superior de Estudios Universitarios La Salle Universidad Autónoma de Madrid Madrid Spain
- Departament of Physiotherapy Universidad CEU Cardenal Herrera CEU Universities Valencia Spain
| | - Roy La Touche
- Motion in Brains Research Group Institute of Neuroscience and Sciences of the Movement (INCIMOV) Centro Superior de Estudios Universitarios La Salle Universidad Autónoma de Madrid Madrid Spain
- Departamento de Fisioterapia Centro Superior de Estudios Universitarios La Salle Universidad Autónoma de Madrid Madrid Spain
- Instituto de Neurociencia y Dolor Craneofacial (INDCRAN) Madrid Spain
- Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ) Madrid Spain
| | - Santiago Angulo‐Díaz‐Parreño
- Motion in Brains Research Group Institute of Neuroscience and Sciences of the Movement (INCIMOV) Centro Superior de Estudios Universitarios La Salle Universidad Autónoma de Madrid Madrid Spain
- Facultad de Medicina Universidad CEU San Pablo Madrid Spain
| | - Ferran Cuenca‐Martínez
- Motion in Brains Research Group Institute of Neuroscience and Sciences of the Movement (INCIMOV) Centro Superior de Estudios Universitarios La Salle Universidad Autónoma de Madrid Madrid Spain
- Departamento de Fisioterapia Centro Superior de Estudios Universitarios La Salle Universidad Autónoma de Madrid Madrid Spain
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17
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Alexander DM, Hutt EA, Lefebvre JS, Bloom GA. Using Imagery to Enhance Performance in Powerlifting: A Review of Theory, Research, and Practice. Strength Cond J 2019. [DOI: 10.1519/ssc.0000000000000490] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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18
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Moukarzel M, Guillot A, Di Rienzo F, Hoyek N. The therapeutic role of motor imagery during the chronic phase after total knee arthroplasty: a pilot randomized controlled trial. Eur J Phys Rehabil Med 2019; 55:806-815. [PMID: 31615192 DOI: 10.23736/s1973-9087.19.05136-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND There is now ample evidence that motor imagery contributes to enhance motor learning and promote motor recovery in patients with motor disorders. Whether motor imagery practice is likely to facilitate mobility in patients suffering from knee osteoarthritis, at 6-months after total knee arthroplasty, remains unknown. AIM This trial was designed to evaluate the therapeutic effectiveness of implementing motor imagery into the classical course of physical therapy at 6-months after total knee arthroplasty. DESIGN Randomized controlled trial. POPULATION Twenty-four patients with unilateral total knee arthroplasty were assigned to a motor imagery or control group in a test-retest procedure, following a rehabilitation program as outpatients. METHODS During both the pre- and post-test, a set of strength and functional mobility measures were assessed: quadriceps strength, peak knee flexion during the swing phase, performance at the timed up and go test, stair climbing test, and 6-minute walk test, and finally Oxford knee score. In addition to a common physical therapy program, the motor imagery group practiced additional motor imagery exercises, while participants of the control group were subjected to a period of neutral activities for an equivalent amount of time. RESULTS Data provided evidence that motor imagery enhanced the quadriceps muscle strength of the operated knee (F (1, 22)=10.36, P=0.003), improved the peak knee flexion during the swing phase (F (1, 22)=31.52, P<0.001), and increased the speed to climb and descend stairs (F (1, 22)=14.28, P=0.001). CONCLUSIONS This study demonstrated the effectiveness of motor imagery exercises in gait performance and functional recovery in a small sample of individuals who underwent total knee arthroplasty. However, before drawing final conclusions sample size calculation should be conducted in the future. CLINICAL REHABILITATION IMPACT While waiting for further research, our findings encourage incorporating motor imagery exercises into classical physical therapy protocols at 6-months after total knee arthroplasty.
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Affiliation(s)
- Marcel Moukarzel
- Inter-University Laboratory of Human Movement Biology (LIBM, EA7424), Claude Bernard Lyon 1 University, Lyon, France.,Faculty of Medicine and Medical Sciences, Holy Spirit University of Jounieh (USEK), Kaslik, Lebanon
| | - Aymeric Guillot
- Inter-University Laboratory of Human Movement Biology (LIBM, EA7424), Claude Bernard Lyon 1 University, Lyon, France.,Institut Universitaire de France (IUF), Paris, France
| | - Franck Di Rienzo
- Inter-University Laboratory of Human Movement Biology (LIBM, EA7424), Claude Bernard Lyon 1 University, Lyon, France
| | - Nady Hoyek
- Inter-University Laboratory of Human Movement Biology (LIBM, EA7424), Claude Bernard Lyon 1 University, Lyon, France -
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19
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Walker T, Salt E, Lynch G, Littlewood C. Screening of the cervical spine in subacromial shoulder pain: A systematic review. Shoulder Elbow 2019; 11:305-315. [PMID: 31316592 PMCID: PMC6620799 DOI: 10.1177/1758573218798023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 05/09/2018] [Accepted: 07/07/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty. Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain. Currently, there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain, which risks patients receiving misguided and/or ineffective interventions. OBJECTIVE To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain. DESIGN Systematic review of randomized controlled trials. METHODS Electronic searches of PEDro and MEDLINE to December 2016 were conducted. Randomized controlled trials evaluating the effectiveness of interventions within the current scope of physiotherapy comprising of adult patients complaining of subacromial shoulder pain were included. Data relating to the method of cervical spine screening were extracted and synthesized categorically. RESULTS One hundred and two studies were included. Twenty-six (25.5%) were categorized as "No method of screening undertaken or reported," 49 (48.0%) were categorized as "Localized cervical spine symptoms and/or radiculopathy/radicular pain," nine (8.8%) were categorized as "Cervical examination," two (2.0%) were categorized as "Manual testing," two (2.0%) were categorized as "History of cervical surgery," and 14 (13.7%) were categorized as using "Combined approaches." CONCLUSION Examination of the cervical spine in patients with subacromial shoulder pain is variable in randomized controlled trials. In many instances, no or minimal attempts to screen were undertaken or reported. This has potential research and management implications and further research is indicated to facilitate development of this aspect of examination.
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Affiliation(s)
- Tom Walker
- Connect Health, Musculoskeletal Service, Dewsbury Health Centre, Dewsbury, UK,Tom Walker, Connect Health, Musculoskeletal Service, Dewsbury Health Centre, Wellington Road, Dewsbury WF13 1HN, UK.
| | - Emma Salt
- Burton Hospitals NHS Foundation Trust, Queen’s Hospital, Burton-on-Trent, UK
| | - Greg Lynch
- Inform Physiotherapy Limited, Silverstream, New Zealand
| | - Chris Littlewood
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele Clinical Trials Unit, David Weatherall Building, Keele University, Keele, UK
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20
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Ribeiro DC, Jafarian Tangrood Z, Sole G, Abbott JH. Effectiveness of a tailored rehabilitation versus standard strengthening programme for patients with shoulder pain: a protocol for a feasibility randomised controlled trial (the Otago MASTER trial). BMJ Open 2019; 9:e028261. [PMID: 31366649 PMCID: PMC6677989 DOI: 10.1136/bmjopen-2018-028261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Exercise therapy is the treatment of choice for the management of patients with shoulder subacromial pain. However, we do not know whether a tailored rehabilitation programme is more effective than a standardised strengthening programme. The aim of this feasibility trial is to assess: (1) participant recruitment rate, (2) the proportion of participants enrolled from the total number screened, (3) adherence to the rehabilitation programme, (4) drop-out rates, (5) obtain estimates of adverse reactions to treatment, (6) obtain estimates of intervention effects in order to inform the sample size of the fully-powered randomised controlled trial, (7) conduct a preliminary cost-effectiveness analysis of the standardised strengthening and the tailored rehabilitation interventions. METHODS The MAnagement of Subacromial disorders of The shouldER (MASTER) trial, is a two-arm, patient-blinded and assessor-blinded, randomised controlled feasibility trial. Participants will be randomly allocated into one of the interventions group: tailored or standardised rehabilitation. To obtain estimates of intervention effects, we will compare changes in pain and shoulder-related disability scores between the two intervention groups using a repeated mixed-model analysis of variance, with alpha set at 0.05, and power at 80%. Since this is a feasibility study, we will not adjust alpha for multiple comparisons. To determine whether it is feasible to conduct the full trial, we will consider 75% CI as the probability threshold at 3-month follow-up. ETHICS AND DISSEMINATION This study was approved by the University of Otago Ethics Committee (Ref: H17/080). Findings from this study will be presented at national and international conferences, and will be submitted for publication in a peer-reviewed journal. TRIAL REGISTRATION NUMBER ANZCTR: 12617001405303.
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Affiliation(s)
- Daniel C Ribeiro
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | | | - Gisela Sole
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - J Haxby Abbott
- Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
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21
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Suso-Martí L, León-Hernández JV, La Touche R, Paris-Alemany A, Cuenca-Martínez F. Motor Imagery and Action Observation of Specific Neck Therapeutic Exercises Induced Hypoalgesia in Patients with Chronic Neck Pain: A Randomized Single-Blind Placebo Trial. J Clin Med 2019; 8:jcm8071019. [PMID: 31336815 PMCID: PMC6678776 DOI: 10.3390/jcm8071019] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 07/05/2019] [Accepted: 07/09/2019] [Indexed: 01/13/2023] Open
Abstract
The aim of the present study was to explore the pain modulation effects of motor imagery (MI) and action observation (AO) of specific neck therapeutic exercises both locally, in the cervical region, and remotely. A single-blind, placebo clinical trial was designed. A total of 30 patients with chronic neck pain (CNP) were randomly assigned to an AO group, MI group, or placebo observation (PO) group. Pain pressure thresholds (PPTs) of C2/C3, trapezius muscles, and epicondyle were the main outcome variables. Secondary outcomes included heart rate measurement. Statistically significant differences were observed in PPTs of the cervical region in the AO and MI groups between the preintervention and first postintervention assessment. Significant differences were found in the AO group in the epicondyle between the preintervention, first and second post-intervention assessments. Regarding heart rate response, differences were found in the AO and MI groups between the preintervention and average intervention measurements. AO and MI induce immediate pain modulation in the cervical region and AO also induces remote hypoalgesia. OA appears to lead to greater pain modulation as well as a greater heart rate response, however, both should be clinically considered in patients with CNP.
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Affiliation(s)
- Luis Suso-Martí
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain
- Department of Physiotherapy, Universidad CEU Cardenal Herrera, CEU Universities, 46115 Valencia, Spain
| | - Jose Vicente León-Hernández
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain
| | - Roy La Touche
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain.
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain.
- Instituto de Neurociencia y Dolor Craneofacial (INDCRAN), 28008 Madrid, Spain.
- Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), 28046 Madrid, Spain.
| | - Alba Paris-Alemany
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain
- Instituto de Neurociencia y Dolor Craneofacial (INDCRAN), 28008 Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), 28046 Madrid, Spain
| | - Ferran Cuenca-Martínez
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain
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Gandola M, Zapparoli L, Saetta G, De Santis A, Zerbi A, Banfi G, Sansone V, Bruno M, Paulesu E. Thumbs up: Imagined hand movements counteract the adverse effects of post-surgical hand immobilization. Clinical, behavioral, and fMRI longitudinal observations. NEUROIMAGE-CLINICAL 2019; 23:101838. [PMID: 31071593 PMCID: PMC6506638 DOI: 10.1016/j.nicl.2019.101838] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 04/08/2019] [Accepted: 04/24/2019] [Indexed: 01/05/2023]
Abstract
Motor imagery (M.I.) training has been widely used to enhance motor behavior. To characterize the neural foundations of its rehabilitative effects in a pathological population we studied twenty-two patients with rhizarthrosis, a chronic degenerative articular disease in which thumb-to-fingers opposition becomes difficult due to increasing pain while the brain is typically intact. Before and after surgery, patients underwent behavioral tests to measure pain and motor performance and fMRI measurements of brain motor activity. After surgery, the affected hand was immobilized, and patients were enrolled in a M.I. training. The sample was split in those who had a high compliance with the program of scheduled exercises (T+, average compliance: 84%) and those with low compliance (T−, average compliance: 20%; cut-off point: 55%). We found that more intense M.I. training counteracts the adverse effects of immobilization reducing pain and expediting motor recovery. fMRI data from the post-surgery session showed that T+ patients had decreased brain activation in the premotor cortex and the supplementary motor area (SMA); meanwhile, for the same movements, the T− patients exhibited a reversed pattern. Furthermore, in the post-surgery fMRI session, pain intensity was correlated with activity in the ipsilateral precentral gyrus and, notably, in the insular cortex, a node of the pain matrix. These findings indicate that the motor simulations of M.I. have a facilitative effect on recovery by cortical plasticity mechanisms and optimization of motor control, thereby establishing the rationale for incorporating the systematic use of M.I. into standard rehabilitation for the management of post-immobilization syndromes characteristic of hand surgery. Motor imagery training counteracts the effects of post-surgical hand immobilization. It also reduces pain and expedites motor recovery after immobilization. These effects were accompanied by significant fMRI signs of brain plasticity. The clinical-fMRI evidence advocates for the use of motor imagery in rehabilitation.
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Affiliation(s)
- Martina Gandola
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
| | | | - Gianluca Saetta
- Neuropsychology Unit, Department of Neurology, University Hospital Zurich, Zurich, Switzerland
| | | | | | - Giuseppe Banfi
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Valerio Sansone
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy; University of Milano-Statale, Milan, Italy
| | | | - Eraldo Paulesu
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy; Department of Psychology and Milan Center for Neuroscience (NeuroMI), University of Milano-Bicocca, Milan, Italy.
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Effects of Virtual Reality-Based Exercise Imagery on Pain in Healthy Individuals. BIOMED RESEARCH INTERNATIONAL 2019; 2019:5021914. [PMID: 31119173 PMCID: PMC6500693 DOI: 10.1155/2019/5021914] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Accepted: 04/01/2019] [Indexed: 11/18/2022]
Abstract
Objective Virtual reality (VR) is an advanced technology that can be used to attenuate pain. The present study aimed to investigate which method was more effective for pain management: VR combined with exercise imagery or VR distraction. Methods Fifty-two healthy students participated in this randomized cross-over controlled trial. One VR-based task aimed to passively use the imagery of driving a car as a distraction intervention (the driving group), whereas the other VR-based task aimed to use exercise imagery (running) to actively engage the participants in movement (the running group). The mechanical pressure pain thresholds of the quadriceps and forearm and the heat pain threshold of the hand of each subject were measured before, during, and after each VR task. The differences between the values at each time point and the differences between the groups were analyzed. Results The pressure and heat pain thresholds were significantly greater during VR task than those before VR task in both driving and running groups. The changes in the pressure pain thresholds that occurred during VR task were significantly higher in the running group than in the driving group. The difference between groups gradually declined after VR task. Conversely, there was no significant difference in the changes in the heat pain thresholds between the groups both during VR task and after VR task. Conclusions VR combined with exercise imagery has a greater effect on pressure pain thresholds, but not heat pain thresholds, than VR distraction.
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Beinert K, Sofsky M, Trojan J. Train the brain! Immediate sensorimotor effects of mentally-performed flexor exercises in patients with neck pain. A pilot study. Eur J Phys Rehabil Med 2019; 55:63-70. [DOI: 10.23736/s1973-9087.18.05118-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Ristori D, Miele S, Rossettini G, Monaldi E, Arceri D, Testa M. Towards an integrated clinical framework for patient with shoulder pain. Arch Physiother 2018; 8:7. [PMID: 29862049 PMCID: PMC5975572 DOI: 10.1186/s40945-018-0050-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 05/23/2018] [Indexed: 01/03/2023] Open
Abstract
Background Shoulder pain (SP) represents a common musculoskeletal condition that requires physical therapy care. Along the years, the usual evaluation strategies based on clinical tests and diagnostic imaging has been challenged. Clinical tests appear unable to clearly identify the structures that generated pain and interpretation of diagnostic imaging is still controversial. The current patho-anatomical diagnostic categories have demonstrated poor reliability and seem inadequate for the SP treatment. Objectives The present paper aims to (1) describe the different proposals of clinical approach to SP currently available in the literature; to (2) integrate these proposals in a single framework in order to help the management of SP. Conclusion The proposed clinical framework, based on a bio-psychosocial vision of health, integrates symptoms characteristics, pain mechanisms and expectations, preferences and psychosocial factors of patients that may guide physiotherapist to make a diagnostic triage and to choose the right treatment for the individual patient.
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Affiliation(s)
- Diego Ristori
- Via Veneto, 6, Subbiano, Arezzo Italy.,7Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, Campus of Savona, Savona, Italy
| | - Simone Miele
- Via Paolo VI, Cologne, Brescia Italy.,7Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, Campus of Savona, Savona, Italy
| | - Giacomo Rossettini
- Via de Gaspari, 9, Montecchio Maggiore, Vicenza Italy.,7Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, Campus of Savona, Savona, Italy
| | - Erica Monaldi
- Via Italo Svevo, 2 Codogno, Lodi, Italy.,7Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, Campus of Savona, Savona, Italy
| | - Diego Arceri
- Via Eugenio Scalfaro, 17, Catanzaro, Italy.,7Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, Campus of Savona, Savona, Italy
| | - Marco Testa
- Via Magliotto, 2 17100, Savona, Italy.,7Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, Campus of Savona, Savona, Italy
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Nakano H, Kodama T, Ukai K, Kawahara S, Horikawa S, Murata S. Reliability and Validity of the Japanese Version of the Kinesthetic and Visual Imagery Questionnaire (KVIQ). Brain Sci 2018; 8:brainsci8050079. [PMID: 29724042 PMCID: PMC5977070 DOI: 10.3390/brainsci8050079] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 04/27/2018] [Accepted: 04/29/2018] [Indexed: 12/24/2022] Open
Abstract
In this study, we aimed to (1) translate the English version of the Kinesthetic and Visual Imagery Questionnaire (KVIQ), which assesses motor imagery ability, into Japanese, and (2) investigate the reliability and validity of the Japanese KVIQ. We enrolled 28 healthy adults in this study. We used Cronbach’s alpha coefficients to assess reliability reflected by the internal consistency. Additionally, we assessed validity reflected by the criterion-related validity between the Japanese KVIQ and the Japanese version of the Movement Imagery Questionnaire-Revised (MIQ-R) with Spearman’s rank correlation coefficients. The Cronbach’s alpha coefficients for the KVIQ-20 were 0.88 (Visual) and 0.91 (Kinesthetic), which indicates high reliability. There was a significant positive correlation between the Japanese KVIQ-20 (Total) and the Japanese MIQ-R (Total) (r = 0.86, p < 0.01). Our results suggest that the Japanese KVIQ is an assessment that is a reliable and valid index of motor imagery ability.
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Affiliation(s)
- Hideki Nakano
- Department of Physical Therapy, Faculty of Health Science, Kyoto Tachibana University, 34 Yamada-cho, Oyake, Yamashina-ku, Kyoto-city, Kyoto 607-8175, Japan.
| | - Takayuki Kodama
- Department of Physical Therapy, Faculty of Health Science, Kyoto Tachibana University, 34 Yamada-cho, Oyake, Yamashina-ku, Kyoto-city, Kyoto 607-8175, Japan.
| | - Kazumasa Ukai
- Department of Physical Therapy, Faculty of Health Science, Kyoto Tachibana University, 34 Yamada-cho, Oyake, Yamashina-ku, Kyoto-city, Kyoto 607-8175, Japan.
| | - Satoru Kawahara
- Department of Physical Therapy, Faculty of Health Science, Kyoto Tachibana University, 34 Yamada-cho, Oyake, Yamashina-ku, Kyoto-city, Kyoto 607-8175, Japan.
| | - Shiori Horikawa
- Department of Physical Therapy, Faculty of Health Science, Kyoto Tachibana University, 34 Yamada-cho, Oyake, Yamashina-ku, Kyoto-city, Kyoto 607-8175, Japan.
| | - Shin Murata
- Department of Physical Therapy, Faculty of Health Science, Kyoto Tachibana University, 34 Yamada-cho, Oyake, Yamashina-ku, Kyoto-city, Kyoto 607-8175, Japan.
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Moukarzel M, Di Rienzo F, Lahoud JC, Hoyek F, Collet C, Guillot A, Hoyek N. The therapeutic role of motor imagery during the acute phase after total knee arthroplasty: a pilot study. Disabil Rehabil 2017; 41:926-933. [PMID: 29275638 DOI: 10.1080/09638288.2017.1419289] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE The aim of this study was to measure physical and functional outcomes during the acute postoperative recovery in patients who underwent total knee arthroplasty. Motor imagery has been shown to decrease pain and promote functional recovery after both neurological and peripheral injuries. Yet, whether motor imagery can be included as an adjunct effective method into physical therapy programs following total knee arthroplasty remains a working hypothesis that we aim to test in a pilot study. METHOD Twenty volunteers were randomly assigned to either a motor imagery or a control group. Pain, range of motion, knee girth as well as quadriceps strength and Timed Up and Go Test time were the dependent variables during pre-test and post-test. RESULTS The motor imagery group exhibited larger decrease of ipsilateral pain and knee girth, a slightly different evolution of range of motion and an increase of ipsilateral quadriceps strength compared to the control group. No effects of motor imagery on Timed Up and Go Test scores were observed. CONCLUSION Implementing motor imagery practice into the course of physical therapy enhanced various physical outcomes during acute postoperative recovery after total knee arthroplasty. According to this pilot study, motor imagery might be relevant to promote motor relearning and recovery after total knee arthroplasty.Partial effect-sizes should be conducted in the future. Implications for rehabilitation Adding motor imagery to physical therapy sessions during the acute period following total knee arthroplasty: • Enhances quadriceps strength. • Alleviates pain. • Enhances range of motion. • Does not have any effect on basic functional mobility. • Does not have any effect on knee girth.
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Affiliation(s)
- Marcel Moukarzel
- a Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM, EA7424), Université Claude Bernard Lyon 1 , Villeurbanne , France.,b Holy Spirit University of Kaslik (USEK), Faculty of Medicine and Medical Sciences , Jounieh , Lebanon
| | - Franck Di Rienzo
- a Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM, EA7424), Université Claude Bernard Lyon 1 , Villeurbanne , France
| | - Jean-Claude Lahoud
- b Holy Spirit University of Kaslik (USEK), Faculty of Medicine and Medical Sciences , Jounieh , Lebanon.,c University College Hospital Notre-Dame de Secours Jbeil, Department of Orthopedics , Byblos , Lebanon
| | - Fadi Hoyek
- b Holy Spirit University of Kaslik (USEK), Faculty of Medicine and Medical Sciences , Jounieh , Lebanon.,c University College Hospital Notre-Dame de Secours Jbeil, Department of Orthopedics , Byblos , Lebanon
| | - Christian Collet
- a Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM, EA7424), Université Claude Bernard Lyon 1 , Villeurbanne , France
| | - Aymeric Guillot
- a Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM, EA7424), Université Claude Bernard Lyon 1 , Villeurbanne , France.,d Institut Universitaire de France (IUF) , Paris , France
| | - Nady Hoyek
- a Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM, EA7424), Université Claude Bernard Lyon 1 , Villeurbanne , France
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Steuri R, Sattelmayer M, Elsig S, Kolly C, Tal A, Taeymans J, Hilfiker R. Effectiveness of conservative interventions including exercise, manual therapy and medical management in adults with shoulder impingement: a systematic review and meta-analysis of RCTs. Br J Sports Med 2017. [PMID: 28630217 PMCID: PMC5574390 DOI: 10.1136/bjsports-2016-096515] [Citation(s) in RCA: 164] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To investigate the effectiveness of conservative interventions for pain, function and range of motion in adults with shoulder impingement. DESIGN Systematic review and meta-analysis of randomised trials. DATA SOURCES Medline, CENTRAL, CINAHL, Embase and PEDro were searched from inception to January 2017. STUDY SELECTION CRITERIA Randomised controlled trials including participants with shoulder impingement and evaluating at least one conservative intervention against sham or other treatments. RESULTS For pain, exercise was superior to non-exercise control interventions (standardised mean difference (SMD) -0.94, 95% CI -1.69 to -0.19). Specific exercises were superior to generic exercises (SMD -0.65, 95% CI -0.99 to -0.32). Corticosteroid injections were superior to no treatment (SMD -0.65, 95% CI -1.04 to -0.26), and ultrasound guided injections were superior to non-guided injections (SMD -0.51, 95% CI -0.89 to -0.13). Nonsteroidal anti-inflammatory drugs (NSAIDS) had a small to moderate SMD of -0.29 (95% CI -0.53 to -0.05) compared with placebo. Manual therapy was superior to placebo (SMD -0.35, 95% CI -0.69 to -0.01). When combined with exercise, manual therapy was superior to exercise alone, but only at the shortest follow-up (SMD -0.32, 95% CI -0.62 to -0.01). Laser was superior to sham laser (SMD -0.88, 95% CI -1.48 to -0.27). Extracorporeal shockwave therapy (ECSWT) was superior to sham (-0.39, 95% CI -0.78 to -0.01) and tape was superior to sham (-0.64, 95% CI -1.16 to -0.12), with small to moderate SMDs. CONCLUSION Although there was only very low quality evidence, exercise should be considered for patients with shoulder impingement symptoms and tape, ECSWT, laser or manual therapy might be added. NSAIDS and corticosteroids are superior to placebo, but it is unclear how these treatments compare to exercise.
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Affiliation(s)
- Ruedi Steuri
- Department of Health, Bern University of Applied Sciences, Berne, Switzerland.,Department of Physiotherapy, University of Applied Sciences Western Switzerland, Leukerbad, Switzerland
| | - Martin Sattelmayer
- Department of Physiotherapy, University of Applied Sciences Western Switzerland, Leukerbad, Switzerland.,School of Health Sciences, HES-SO Valais-Wallis, University of Applied Sciences and Arts Western Switzerland Valais, Leukerbad, Switzerland
| | - Simone Elsig
- Department of Physiotherapy, University of Applied Sciences Western Switzerland, Leukerbad, Switzerland.,School of Health Sciences, HES-SO Valais-Wallis, University of Applied Sciences and Arts Western Switzerland Valais, Leukerbad, Switzerland
| | - Chloé Kolly
- Department of Physiotherapy, University of Applied Sciences Western Switzerland, Leukerbad, Switzerland.,School of Health Sciences, HES-SO Valais-Wallis, University of Applied Sciences and Arts Western Switzerland Valais, Leukerbad, Switzerland
| | - Amir Tal
- Department of Health, Bern University of Applied Sciences, Berne, Switzerland
| | - Jan Taeymans
- Department of Health, Bern University of Applied Sciences, Berne, Switzerland.,Faculty of Sport and Rehabilitation Science, Vrije Universiteit Brussel, Brussels, Belgium
| | - Roger Hilfiker
- Department of Physiotherapy, University of Applied Sciences Western Switzerland, Leukerbad, Switzerland.,School of Health Sciences, HES-SO Valais-Wallis, University of Applied Sciences and Arts Western Switzerland Valais, Leukerbad, Switzerland
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Scott M, Taylor S, Chesterton P, Vogt S, Eaves DL. Motor imagery during action observation increases eccentric hamstring force: an acute non-physical intervention. Disabil Rehabil 2017; 40:1443-1451. [DOI: 10.1080/09638288.2017.1300333] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Matthew Scott
- Department of Psychology, Sport and Exercise, Teesside University, Middlesbrough, United Kingdom
| | - Stephen Taylor
- Department of Psychology, Sport and Exercise, Teesside University, Middlesbrough, United Kingdom
| | - Paul Chesterton
- Department of Psychology, Sport and Exercise, Teesside University, Middlesbrough, United Kingdom
| | - Stefan Vogt
- Department of Psychology, Lancaster University, Lancaster, United Kingdom
| | - Daniel Lloyd Eaves
- Department of Psychology, Sport and Exercise, Teesside University, Middlesbrough, United Kingdom
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Eaves DL, Riach M, Holmes PS, Wright DJ. Motor Imagery during Action Observation: A Brief Review of Evidence, Theory and Future Research Opportunities. Front Neurosci 2016; 10:514. [PMID: 27917103 PMCID: PMC5116576 DOI: 10.3389/fnins.2016.00514] [Citation(s) in RCA: 136] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 10/25/2016] [Indexed: 01/28/2023] Open
Abstract
Motor imagery (MI) and action observation (AO) have traditionally been viewed as two separate techniques, which can both be used alongside physical practice to enhance motor learning and rehabilitation. Their independent use has largely been shown to be effective, and there is clear evidence that the two processes can elicit similar activity in the motor system. Building on these well-established findings, research has now turned to investigate the effects of their combined use. In this article, we first review the available neurophysiological and behavioral evidence for the effects of combined action observation and motor imagery (AO+MI) on motor processes. We next describe a conceptual framework for their combined use, and then discuss several areas for future research into AO+MI processes. In this review, we advocate a more integrated approach to AO+MI techniques than has previously been adopted by movement scientists and practitioners alike. We hope that this early review of an emergent body of research, along with a related set of research questions, can inspire new work in this area. We are optimistic that future research will further confirm if, how, and when this combined approach to AO+MI can be more effective in motor learning and rehabilitation settings, relative to the more traditional application of MI or AO independently.
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Affiliation(s)
- Daniel L. Eaves
- Sport and Exercise Science Section, Teesside UniversityMiddlesbrough, UK
| | - Martin Riach
- Research Centre for Health, Exercise and Active Living, Manchester Metropolitan UniversityCrewe, UK
| | - Paul S. Holmes
- Research Centre for Health, Exercise and Active Living, Manchester Metropolitan UniversityCrewe, UK
| | - David J. Wright
- Research Centre for Health, Exercise and Active Living, Manchester Metropolitan UniversityCrewe, UK
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Thieme H, Morkisch N, Rietz C, Dohle C, Borgetto B. The Efficacy of Movement Representation Techniques for Treatment of Limb Pain--A Systematic Review and Meta-Analysis. THE JOURNAL OF PAIN 2015; 17:167-80. [PMID: 26552501 DOI: 10.1016/j.jpain.2015.10.015] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 09/29/2015] [Accepted: 10/14/2015] [Indexed: 11/27/2022]
Abstract
UNLABELLED Relatively new evidence suggests that movement representation techniques (ie, therapies that use the observation and/or imagination of normal pain-free movements, such as mirror therapy, motor imagery, or movement and/or action observation) might be effective in reduction of some types of limb pain. To summarize the evidence regarding the efficacy of those techniques, a systematic review with meta-analysis was performed. We searched Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, AMED, PsychINFO, Physiotherapy Evidence Database, and OT-seeker up to August 2014 and hand-searched further relevant resources for randomized controlled trials that studied the efficacy of movement representation techniques in reduction of 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, poststroke pain, and nonpathological (acute) pain. Overall, movement representation techniques were found to be effective in reduction of pain (standardized mean difference [SMD] = -.82, 95% confidence interval [CI], -1.32 to -.31, P = .001) and disability (SMD = .72, 95% CI, .22-1.22, P = .004) and showed a positive but nonsignificant effect on quality of life (SMD = 2.61, 85% CI, -3.32 to 8.54, P = .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 effect of movement representation techniques in patients with phantom limb pain and poststroke pain other than complex regional pain syndrome. PERSPECTIVE In this systematic review we synthesize the evidence for the efficacy of movement representation techniques (ie, motor imagery, mirror therapy, or action observation) for treatment of limb pain. Our findings suggest effective pain reduction in some types of limb pain. Further research should address specific questions on the optimal type and dose of therapy.
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Affiliation(s)
- Holm Thieme
- Faculty of Social Work and Health, University of Applied Sciences and Arts, Hildesheim, Germany; First European School for Physiotherapy, Occupational Therapy, and Speech and Language Therapy, Clinic Bavaria Kreischa, Kreischa, Germany.
| | - Nadine Morkisch
- MEDIAN Clinic Berlin-Kladow, Berlin, Germany; Center for Stroke Research Berlin, Charité - University Medicine Berlin, Berlin, Germany
| | - Christian Rietz
- Department of Special Education and Rehabilitation, Faculty of Human Sciences, University of Cologne, Germany
| | - Christian Dohle
- MEDIAN Clinic Berlin-Kladow, Berlin, Germany; Center for Stroke Research Berlin, Charité - University Medicine Berlin, Berlin, Germany
| | - Bernhard Borgetto
- Faculty of Social Work and Health, University of Applied Sciences and Arts, Hildesheim, Germany
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Addressing Neuroplastic Changes in Distributed Areas of the Nervous System Associated With Chronic Musculoskeletal Disorders. Phys Ther 2015; 95:1582-91. [PMID: 25953594 DOI: 10.2522/ptj.20140575] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 05/01/2015] [Indexed: 11/17/2022]
Abstract
Present interventions utilized in musculoskeletal rehabilitation are guided, in large part, by a biomedical model where peripheral structural injury is believed to be the sole driver of the disorder. There are, however, neurophysiological changes across different areas of the peripheral and central nervous systems, including peripheral receptors, dorsal horn of the spinal cord, brain stem, sensorimotor cortical areas, and the mesolimbic and prefrontal areas associated with chronic musculoskeletal disorders, including chronic low back pain, osteoarthritis, and tendon injuries. These neurophysiological changes appear not only to be a consequence of peripheral structural injury but also to play a part in the pathophysiology of chronic musculoskeletal disorders. Neurophysiological changes are consistent with a biopsychosocial formulation reflecting the underlying mechanisms associated with sensory and motor findings, psychological traits, and perceptual changes associated with chronic musculoskeletal conditions. These changes, therefore, have important implications in the clinical manifestation, pathophysiology, and treatment of chronic musculoskeletal disorders. Musculoskeletal rehabilitation professionals have at their disposal tools to address these neuroplastic changes, including top-down cognitive-based interventions (eg, education, cognitive-behavioral therapy, mindfulness meditation, motor imagery) and bottom-up physical interventions (eg, motor learning, peripheral sensory stimulation, manual therapy) that induce neuroplastic changes across distributed areas of the nervous system and affect outcomes in patients with chronic musculoskeletal disorders. Furthermore, novel approaches such as the use of transcranial direct current stimulation and repetitive transcranial magnetic stimulation may be utilized to help renormalize neurological function. Comprehensive treatment addressing peripheral structural injury as well as neurophysiological changes occurring across distributed areas of the nervous system may help to improve outcomes in patients with chronic musculoskeletal disorders.
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Volz MS, Suarez-Contreras V, Portilla ALS, Fregni F. Mental imagery-induced attention modulates pain perception and cortical excitability. BMC Neurosci 2015; 16:15. [PMID: 25887060 PMCID: PMC4387598 DOI: 10.1186/s12868-015-0146-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 02/18/2015] [Indexed: 11/19/2022] Open
Abstract
Background Mental imagery is a powerful method of altering brain activity and behavioral outcomes, such as performance of cognition and motor skills. Further, attention and distraction can modulate pain-related neuronal networks and the perception of pain. This exploratory study examined the effects of mental imagery-induced attention on pressure pain threshold and cortical plasticity using transcranial magnetic stimulation (TMS). This blinded, randomized, and parallel-design trial comprised 30 healthy right-handed male subjects. Exploratory statistical analyses were performed using ANOVA and t-tests for pain and TMS assessments. Pearson’s correlation was used to analyze the association between changes in pain threshold and cortical excitability. Results In the analysis of pain outcomes, there was no significant interaction effect on pain between group versus time. In an exploratory analysis, we only observed a significant effect of group for the targeted left hand (ANOVA with pain threshold as the dependent variable and time and group as independent variables). Although there was only a within-group effect of mental imagery on pain, further analyses showed a significant positive correlation of changes in pain threshold and cortical excitability (motor-evoked potentials via TMS). Conclusions Mental imagery has a minor effect on pain modulation in healthy subjects. Its effects appear to differ compared with chronic pain, leading to a small decrease in pain threshold. Assessments of cortical excitability confirmed that these effects are related to the modulation of pain-related cortical circuits. These exploratory findings suggest that neuronal plasticity is influenced by pain and that the mental imagery effects on pain depend on the state of central sensitization.
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Affiliation(s)
- Magdalena Sarah Volz
- Laboratory of Neuromodulation, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, 125 Nashua Street #727, Boston, 02114, MA, USA. .,Charité - Universitätsmedizin, Berlin, Germany.
| | - Vanessa Suarez-Contreras
- Laboratory of Neuromodulation, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, 125 Nashua Street #727, Boston, 02114, MA, USA.
| | - Andrea L Santos Portilla
- Laboratory of Neuromodulation, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, 125 Nashua Street #727, Boston, 02114, MA, USA.
| | - Felipe Fregni
- Laboratory of Neuromodulation, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, 125 Nashua Street #727, Boston, 02114, MA, USA. .,Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
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