Graded motor imagery may improve outcomes in patients with post-traumatic elbow stiffness
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Published results showed graded motor imagery may improve function, elbow active range of motion, pain, fear of movement-related pain and muscle strength in patients with post-traumatic elbow stiffness.
“The present study provides evidence that the addition of [graded motor imagery (GMI)] to a postoperative elbow rehabilitation program may contribute to a significant reduction in pain intensity and pain related fear of movement and improvements in functional level in patients with post-traumatic elbow stiffness,” the authors wrote.
Researchers separated 50 patients with post-traumatic elbow stiffness to either a GMI program (n=25) which consisted of left/right discrimination, motor imagery and mirror therapy twice a week for 6 weeks or a structured exercise program (n=25) which consisted of range of motion, stretching and strengthening exercises twice a week for 6 weeks. Researchers reported both groups also underwent a 6-week home exercise program. Researchers assessed patients at baseline, at the end of the 12-session treatment and at 6-week follow-up using the DASH score as the primary outcome and active range of motion, VAS score, Tampa Scale for Kinesiophobia, muscle strength of elbow flexors and extensors, grip strength, left/right discrimination and global rating of change as the secondary outcomes.
Although both patients in the GMI and structured exercise interventions had significantly improved outcomes, results showed significantly improved DASH scores after a 6-week intervention with a medium effect size in the GMI group vs. the structured exercise group. After the 6-week intervention, researchers found 80% of patients in the GMI group and 72% of patients in the structured exercise group reported that they had improved significantly. Researchers noted the GMI group also had significant results with a medium to large effect size for elbow flexion active range of motion, VAS-activity, Tampa Scale for Kinesiophobia, muscle strength of elbow flexors and elbow extensors.
“GMI, a motor-cognitive intervention program, is an effective method in post-traumatic elbow stiffness rehabilitation to counteract the detrimental effects of immobilization and fear of movement-related pain without stressing the injured side,” the authors wrote. “Future research could investigate the efficacy of alternative intervention programs that focus on the cognitive system and the musculoskeletal system in the post-traumatic stiffness of the upper limb.”
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