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Marie-Éve Lamarche, M.ScA(OT),
Erg. University of Montreal with the collaboration of Sacré-Coeur Hospital in Montréal
Montréal, Québec
Use of Graded Motor Imagery with Patients Suffering from Type I Complex Regional Pain Syndrome
Introduction: Type I Complex Regional Pain Syndrome (CRPS) is a challenging condition to treat effectively. There is limited evidence to support current treatment techniques to manage this condition. However, recent insights on the pathophysiology of this syndrome have inspired the creation of new treatment approaches such as Graded Motor Imagery (GMI). This technique consists of 6 weeks of treatment dividided into three different phases: laterality reconstruction; motor imagery, and mirror therapy.
Objectives: To verify the effectiveness of the GMI program with clients suffering from Type I CRPS.
Methods:: Search in Medline and Pubmed from 1996 to September 2009 using the following key terms alone or in combination: "complex regional pain syndrome or reflex sympathetic dystrohpy or algodystrophy or chronic arm pain" and "physical therapy modalities or occupational therapy modalities or therapy or rehabilitation" and "motor imagery or graded motor imagery or mirror therapy or mirror visual feedback" and "adult". Articles were selected based on titles, summaries, and relevance to the subject.
Results:: The review of the literature shows the effectiveness of GMI on clients with Type I CRPS to reduce symptoms of pain, edema and disability. Furthermore, GMI is inexpensive, non invasive and can provide significant clinical benefits to the client. There is little supervision necessary from the therapist and it favours empowerment of the client towards his therapy.
Conclusion: The potential benefits of the implementation of the GMI program are important considering that its efficiency has been demonstrated. Furthermore, most other treatments in rehabilitation are not supported by scientific evidence. The GMI program should then be one of the first treatment techniques to be used for clients suffering from Type I CRPS. The implementation of this program has already started at the Sacré-Cœur Hospital in Montreal, Quebec and has been facilitated by the designing of the different tools for the execution of the three phases (photo-cards, computer software and the mirror box).