The Efficacy of Graded Motor Imagery and Its Components on Phantom Limb Pain and Disability: A Systematic Review and Meta-Analysis
ABSTRACTIntroduction Graded Motor Imagery (GMI) is a non-invasive and inexpensive therapy used to treat Phantom Limb Pain (PLP) by sequentially activating motor networks in such a way that movement and pain are unpaired. The objective of this systematic review was to critically appraise relevant dat...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2023-12-01
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| Series: | Canadian Journal of Pain |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/24740527.2023.2188899 |
| _version_ | 1797448949121941504 |
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| author | Katleho Limakatso Aidan G. Cashin Sam Williams Jack Devonshire Romy Parker James H. McAuley |
| author_facet | Katleho Limakatso Aidan G. Cashin Sam Williams Jack Devonshire Romy Parker James H. McAuley |
| author_sort | Katleho Limakatso |
| collection | DOAJ |
| description | ABSTRACTIntroduction Graded Motor Imagery (GMI) is a non-invasive and inexpensive therapy used to treat Phantom Limb Pain (PLP) by sequentially activating motor networks in such a way that movement and pain are unpaired. The objective of this systematic review was to critically appraise relevant data on the efficacy of GMI and its components for reducing PLP and disability in amputees.Methods We searched 11 electronic databases for controlled trials investigating GMI and its components in amputees with PLP from inception until February 2023. Two reviewers independently screened studies and extracted relevant data. Study-level data were entered using the inverse variance function of the Review Manager 5 and pooled with the random effects model.Results Eleven studies with varying risk of bias were eligible. No eligible study considered left/right judgement tasks in isolation. Studies showed no effect for imagined movements, but positive effects were seen for GMI [weighted mean difference: -21.29 (95%CI: -31.55, -11.02), I2= 0%] and mirror therapy [weighted mean difference: -8.55 (95%CI: -14.74, -2.35, I2= 61%]. A comparison of mirror therapy versus sham showed no difference [weighted mean difference: -4.43 (95%CI: -16.03, 7.16), I2= 51%].Conclusion Our findings suggest that GMI and mirror therapy may be effective for reducing PLP. However, this conclusion was drawn from a limited body of evidence, and the certainty of the evidence was very low. Therefore, rigorous, high-quality trials are needed to address the gap in the literature and inform practice. |
| first_indexed | 2024-03-09T14:17:57Z |
| format | Article |
| id | doaj.art-a92e6b40535841cb9eecb5219341d7a2 |
| institution | Directory Open Access Journal |
| issn | 2474-0527 |
| language | English |
| last_indexed | 2024-03-09T14:17:57Z |
| publishDate | 2023-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Canadian Journal of Pain |
| spelling | doaj.art-a92e6b40535841cb9eecb5219341d7a22023-11-28T20:20:17ZengTaylor & Francis GroupCanadian Journal of Pain2474-05272023-12-017110.1080/24740527.2023.2188899The Efficacy of Graded Motor Imagery and Its Components on Phantom Limb Pain and Disability: A Systematic Review and Meta-AnalysisKatleho Limakatso0Aidan G. Cashin1Sam Williams2Jack Devonshire3Romy Parker4James H. McAuley5School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, AustraliaSchool of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, AustraliaSchool of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, AustraliaSchool of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, AustraliaPain Management Unit, Department of Anaesthesia and Perioperative Medicine, University of Cape Town, Cape Town, South AfricaSchool of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, AustraliaABSTRACTIntroduction Graded Motor Imagery (GMI) is a non-invasive and inexpensive therapy used to treat Phantom Limb Pain (PLP) by sequentially activating motor networks in such a way that movement and pain are unpaired. The objective of this systematic review was to critically appraise relevant data on the efficacy of GMI and its components for reducing PLP and disability in amputees.Methods We searched 11 electronic databases for controlled trials investigating GMI and its components in amputees with PLP from inception until February 2023. Two reviewers independently screened studies and extracted relevant data. Study-level data were entered using the inverse variance function of the Review Manager 5 and pooled with the random effects model.Results Eleven studies with varying risk of bias were eligible. No eligible study considered left/right judgement tasks in isolation. Studies showed no effect for imagined movements, but positive effects were seen for GMI [weighted mean difference: -21.29 (95%CI: -31.55, -11.02), I2= 0%] and mirror therapy [weighted mean difference: -8.55 (95%CI: -14.74, -2.35, I2= 61%]. A comparison of mirror therapy versus sham showed no difference [weighted mean difference: -4.43 (95%CI: -16.03, 7.16), I2= 51%].Conclusion Our findings suggest that GMI and mirror therapy may be effective for reducing PLP. However, this conclusion was drawn from a limited body of evidence, and the certainty of the evidence was very low. Therefore, rigorous, high-quality trials are needed to address the gap in the literature and inform practice.https://www.tandfonline.com/doi/10.1080/24740527.2023.2188899Phantom limb painmirror therapyimagined movementsleft/right judgmentsgraded motor imageryamputation |
| spellingShingle | Katleho Limakatso Aidan G. Cashin Sam Williams Jack Devonshire Romy Parker James H. McAuley The Efficacy of Graded Motor Imagery and Its Components on Phantom Limb Pain and Disability: A Systematic Review and Meta-Analysis Canadian Journal of Pain Phantom limb pain mirror therapy imagined movements left/right judgments graded motor imagery amputation |
| title | The Efficacy of Graded Motor Imagery and Its Components on Phantom Limb Pain and Disability: A Systematic Review and Meta-Analysis |
| title_full | The Efficacy of Graded Motor Imagery and Its Components on Phantom Limb Pain and Disability: A Systematic Review and Meta-Analysis |
| title_fullStr | The Efficacy of Graded Motor Imagery and Its Components on Phantom Limb Pain and Disability: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | The Efficacy of Graded Motor Imagery and Its Components on Phantom Limb Pain and Disability: A Systematic Review and Meta-Analysis |
| title_short | The Efficacy of Graded Motor Imagery and Its Components on Phantom Limb Pain and Disability: A Systematic Review and Meta-Analysis |
| title_sort | efficacy of graded motor imagery and its components on phantom limb pain and disability a systematic review and meta analysis |
| topic | Phantom limb pain mirror therapy imagined movements left/right judgments graded motor imagery amputation |
| url | https://www.tandfonline.com/doi/10.1080/24740527.2023.2188899 |
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