Cited by 681Pain Management and TreatmentStroke Rehabilitation and RecoveryPain Mechanisms and Treatments

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Graded motor imagery is effective for long-standing complex regional pain syndrome: a randomised controlled trial

Moseley, L G.·2004·Pain

DOI 10.1016/j.pain.2004.01.006

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Abstract

Complex regional pain syndrome type 1 (CRPS1) involves cortical abnormalities similar to those observed in phantom pain and after stroke. In those groups, treatment is aimed at activation of cortical networks that subserve the affected limb, for example mirror therapy. However, mirror therapy is not effective for chronic CRPS1, possibly because movement of the limb evokes intolerable pain. It was hypothesised that preceding mirror therapy with activation of cortical networks without limb movement would reduce pain and swelling in patients with chronic CRPS1. Thirteen chronic CRPS1 patients were randomly allocated to a motor imagery program (MIP) or to ongoing management. The MIP consisted of two weeks each of a hand laterality recognition task, imagined hand movements and mirror therapy. After 12 weeks, the control group was crossed-over to MIP. There was a main effect of treatment group (F(1, 11) = 57, P < 0.01) and an effect size of approximately 25 points on the Neuropathic pain scale. The number needed to treat for a 50% reduction in NPS score was approximately 2. The effect of treatment was replicated in the crossed-over control subjects. The results uphold the hypothesis that a MIP initially not involving limb movement is effective for CRPS1 and support the involvement of cortical abnormalities in the development of this disorder. Although the mechanisms of effect of the MIP are not clear, possible explanations are sequential activation of cortical pre-motor and motor networks, or sustained and focussed attention on the affected limb, or both.

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Authors: Moseley, L. G.
Venue: Pain
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2004-03
Volume: 108
Issue: 1
Pages: 192-198
ISSN: 0304-3959 (ISSN-L)
DOI: 10.1016/j.pain.2004.01.006
OpenAlex: W2171940221
Cited by: 681
References: 42
Citations by year: 2026: 19 · 2025: 32 · 2024: 20 · 2023: 35 · 2022: 30 · 2021: 31 · 2020: 32 · 2019: 27 · 2018: 37 · 2017: 45 · 2016: 38 · 2015: 39 · 2014: 35 · 2013: 41 · 2012: 44
FWCI: 20.29
Type: journal article
Language: en
Open access: closed
Locations: Pain (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
Health Sciences › Medicine › Physiology (medical) › Pain Mechanisms and Treatments
Keywords: complex regional pain syndrome type I, graded motor imagery, mirror therapy, cortical abnormalities, neuropathic pain, phantom pain, chronic pain
MeSH terms: Adolescent, Adult, Chronic Disease, Female, Humans, Male, Middle Aged, Motor Cortex, Reflex Sympathetic Dystrophy, Treatment Outcome, Cross-Over Studies, Imagery, Psychotherapy, Physical Therapy Modalities

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Graded motor imagery is effective for long-standing complex regional pain syndrome: a randomised controlled trial

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