Functional Imaging Unit. Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany.
IIMPACT in Health, University of South Australia, Kaurna Country, Adelaide, Australia.
J Pain. 2022 Sep;23(9):1480-1491. doi: 10.1016/j.jpain.2022.04.008. Epub 2022 Apr 30.
Movement limitation is a common characteristic of chronic pain such that pain prevents the very movement and activity that is most likely to promote recovery. This is particularly the case for pathological pain states such as complex regional pain syndrome (CRPS). One clinical approach to CRPS that has growing evidence of efficacy involves progressive movement imagery training. Graded Motor Imagery (GMI) targets clinical and neurophysiological effects through a stepwise progression through implicit and explicit movement imagery training, mirror therapy and then functional tasks. Here we review experiences from over 20 years of clinical and research experience with GMI. We situate GMI in terms of its historical underpinnings, the benefits and outstanding challenges of its implementation, its potential application beyond CRPS. We then review the neuropathological targets of GMI and current thought on its effects on neurophysiological biomarkers. PERSPECTIVE: This article provides an overview of our experiences with graded motor imagery training over the last 20 years focussing on the treatment of CRPS. It does both cover the theoretical underpinnings for this treatment approach, biomarkers which indicate potential changes driven by GMI, and experiences for achieving optimal treatment results.
运动受限是慢性疼痛的一个常见特征，以至于疼痛阻止了最有可能促进康复的运动和活动。病理性疼痛状态，如复杂性区域疼痛综合征（CRPS），尤其如此。一种针对 CRPS 的临床方法，即渐进式运动想象训练，其疗效的证据越来越多。分级运动想象（GMI）通过逐步进行内隐和外显运动想象训练、镜像治疗和功能任务来针对临床和神经生理学效果。在这里，我们回顾了 20 多年来在临床和研究方面使用 GMI 的经验。我们根据其历史背景、实施的益处和突出挑战、其在 CRPS 之外的潜在应用来定位 GMI。然后，我们回顾了 GMI 的神经病理学靶点和目前关于其对神经生理生物标志物影响的思考。观点：本文概述了我们在过去 20 年中使用分级运动想象训练的经验，重点是治疗 CRPS。它既涵盖了这种治疗方法的理论基础，也涵盖了表明 GMI 驱动潜在变化的生物标志物，以及获得最佳治疗效果的经验。
