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The Effects of Motor Imagery on Pain and Range of Motion in Musculoskeletal Disorders

A Systematic Review Using Meta-Analysis

Yap, Benjamin Wei Da, BSc (Hons)*; Lim, Edwin Choon Wyn, PhD†,‡

doi: 10.1097/AJP.0000000000000648
Review Articles

Introduction: In recent years, there has been an increase in the use of motor imagery (MI) in the rehabilitation of musculoskeletal pain conditions. Across the literature, most reviews have yet to consider Laterality Judgement Task training as a form of MI method. This review aimed to evaluate the effectiveness of using MI as an adjunct to standard rehabilitation on the improvement of pain and range of motion parameters when managing patients with musculoskeletal pain conditions.

Methods: Searches of 8 major electronic databases were conducted. Data for pain and range of motion were extracted. Meta-analyses (where possible) with either a fixed or random-effect(s) model, standardized mean differences (SMDs), and tests of heterogeneity were performed.

Results: Eight clinical controlled trials were identified and included in the meta-analyses. When compared with standard rehabilitation alone, the adjunctive role of MI provided superior pain relief (pooled SMD, −2.25; 95% confidence interval, −4.11 to −0.4; P=0.02), and greater improvement in range of motion (pooled SMD, 3.04; 95% confidence interval, 0.66-5.43; P=0.01) in chronic musculoskeletal pain disorders.

Discussion: The results suggest that MI may be effective for pain relief and improvement in range of motion among chronic musculoskeletal pain conditions, although conclusion is based on a limited certainty of evidence as assessed using the GRADES (Grading of Recommendation, Assessment, Development and Evaluation) approach.

Departments of *Occupational Therapy

Physiotherapy, Singapore General Hospital

Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore

The authors declare no conflict of interest.

Reprints: Benjamin Wei Da Yap, BSc (Hons), 5 Hospital Drive, National Heart Centre Level 7, Singapore General Hospital Rehabilitation Centre, Singapore 169609, Singapore (e-mail:

Received February 20, 2018

Received in revised form August 20, 2018

Accepted August 29, 2018

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