Graded Motor Imagery | Treatment for pain and movement disorders

We use Graded Motor Imagery (GMI) for the treatment of pain and injury as part of a tailored programme of therapy. GMI has been a hugely significant step forward in the way we approach pain as it targets the brain and the changes that occur in persisting pain and injury.

Examples of conditions and problems that we treat with GMI:

  • Complex Regional Pain Syndrome (CRPS/RSD)
  • Repetitive Strain Injury (RSI)
  • Back pain
  • Neck pain
  • Tendinopathy
  • Arthritis
  • Neuropathic pain

What is GMI?

GMI is a three stage programme that sequentially targets the processes that underpin normal movement and sense of the body:

  • Laterality
  • Imagery
  • Mirror therapy

When we move the brain makes a left/right judgement that is a normal part of the planning of movement. We know that this process is both delayed and less accurate in pain and injury. The Recognise tool online allows us to identify changes in laterality and then provide focused brain training to improve the brain’s ability to plan movement.

In the clinics we have the equipment and resources for GMI training. This includes the Recognise online programme, imagery techniques and the mirror box.

It is important that the training is performed at home between the clinic sessions. The GMI tools are available from NOIgroup– call Joanna on 01904 737919 or on the website

Further information and videos

David Butler talks about GMI

Part 1

Part 2

Part 3

Part 4

References

Chan, BL et al. (2007) New England Journal of Medicine 357:2206-7

Daly, A.E. & Bialocerkowski, A.E. (2008) Does evidence support physiotherapy management of adult Complex Regional Pain Syndrome Type One? A systematic review. Eur J Pain, 13(4), 339-353.

Diers, M., Christmann, C., Koeppe, C. et al. (2010) Mirrored, imagined and executed movements differentially activate sensorimotor cortex in amputees with and without phantom limb pain. Pain, 149(2), 296-304.

MacIver, K., Lloyd, D.M., Kelly, S. et al. (2008) Phantom limb pain, cortical reorganization and the therapeutic effect of mental imagery. Brain, 131(Pt 8), 2181-2191.

Moseley, G. L. (2005) Pain 114: 54-61.

Moseley, G. L. (2006) Neurology 67: 1-6

McCabe, CS et al. (2004) Novartis Foundation Symposia 260: 154-174

Moseley, G.L., Zalucki, N., Birklein, F. et al. (2008) Thinking about movement hurts: The effect of motor imagery on pain and swelling in people with chronic arm pain. Arthritis and Rheumatism, 59(5), 623-631.

Moseley, G.L. (2009) Reflections, imagery and illusions: the past, present and future of training the brain in CRPS. RSDSA Review, 22(1), 9-10.

Nico, D., Daprati, E., Rigal, F. et al. (2004) Left and right hand recognition in upper limb amputees. Brain, 127 (1), 120-132.

Rosen, B. and G. Lundborg (2005) Scandinavian Journal of Plastic and Reconstructive Surgery 39: 104-108.

Stenekes, M.W., Geertzen, J.H., Nicolai, J.P. et al. (2009) Effects of motor imagery on hand function during immobilization after flexor tendon repair. Arch Phys Med Rehabil, 90(4), 553-559.

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