Flebus Julie, Martín Núñez Javier, Granados Santiago María, Heredia Ciuró Alejandro, Calvache Mateo Andrés, Navas Otero Alba, Carmen Valenza Marie
Université Versailles-Saint Quentin en Yvelines Institut de Formationen Masso-Kinésithérapie-Assas, Pairs, France.
Department of Physiotherapy, University of Granada, Granada, Spain.
Eur J Pain. 2025 Oct;29(9):e70100. doi: 10.1002/ejp.70100.
INTRODUCTION: A highly prevalent condition, knee pain often results in significant functional limitations and a reduced quality of life. Due to its multifactorial causes and diverse pathologies, numerous therapeutic approaches have been proposed, each with varying degrees of success. Among these, movement representation strategies have emerged as promising interventions. These techniques engage the central nervous system by using mental simulation of motor actions-such as motor imagery and action observation-without the need for actual physical movement, often focusing on imagining or observing pain-free, unrestricted motion. METHODS: Because the effectiveness of movement representation strategies in knee pain remains uncertain and no prior synthesis of randomised evidence exists, a systematic review of the literature was conducted for randomised controlled trials indexed from three databases inception to March 2025. Two reviewers performed independent data extraction and methodologic quality assessment of the studies. RESULTS: Eleven studies were included in this review. The results of pain and function outcomes showed significant improvements after interventions based on movement representation techniques. The meta-analyses showed that these techniques have a significant effect on pain and function. DISCUSSION AND CONCLUSION: The results of our review demonstrated notable results from the implementation of movement representation techniques to standard physical therapy aimed at decreasing pain and increasing function in patients with knee pain. The meta-analyses revealed a significant positive effect of these interventions. SIGNIFICANCE STATEMENT: Movement representation strategies combined with physical therapy have a significant effect on function and pain in patients with knee pain. The most commonly used strategies were motor imagery training and action observation training. The meta-analyses revealed a significant positive effect of these interventions, showing improvements in both pain and function in patient with knee pain.
引言：膝关节疼痛是一种高度普遍的病症，常常导致严重的功能受限和生活质量下降。由于其病因多因素且病理多样，人们提出了众多治疗方法，但每种方法的成功率各不相同。其中，运动表象策略已成为有前景的干预措施。这些技术通过对运动动作进行心理模拟（如运动想象和动作观察）来激活中枢神经系统，而无需实际的身体运动，通常专注于想象或观察无痛、不受限的动作。 方法：由于运动表象策略对膝关节疼痛的有效性仍不确定，且此前尚无随机证据的综合分析，因此对从三个数据库建库至2025年3月索引的随机对照试验进行了系统的文献综述。两名评审员对研究进行了独立的数据提取和方法学质量评估。 结果：本综述纳入了11项研究。疼痛和功能结局的结果显示，基于运动表象技术的干预后有显著改善。荟萃分析表明，这些技术对疼痛和功能有显著影响。 讨论与结论：我们的综述结果表明，将运动表象技术应用于标准物理治疗以减轻膝关节疼痛患者的疼痛并提高其功能，取得了显著成果。荟萃分析揭示了这些干预措施具有显著的积极效果。 意义声明：运动表象策略与物理治疗相结合对膝关节疼痛患者的功能和疼痛有显著影响。最常用的策略是运动想象训练和动作观察训练。荟萃分析揭示了这些干预措施具有显著的积极效果，显示膝关节疼痛患者的疼痛和功能均有改善。
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