Effectiveness of motor imagery and action observation training on musculoskeletal pain intensity: A systematic review and meta‐analysis

Abstract

Background and Objective:Movement representation techniques such as motor imagery (MI) and action observation (AO) could play an important role in the field of rehabilitation of patients with musculoskeletal pain; however, the effects of these tools on clinical pain remain unclear. Our objective is therefore to develop a systematic review and meta-analysis of the effects of MI and AO regarding the pain intensity on patients with musculoskeletal pain. Databases and Data Treatment: MEDLINE, EMBASE, CINAHL and Google Scholar were searched. Last search was run on July 2019. Meta-analysis was conducted to determine the effectiveness on pain intensity in patients with post-surgical pain or chronic pain, and GRADE was used to rate the quality, certainty and applicability of the evidence. Results: A total of 10 studies were included. AO or MI were compared versus usual rehabilitation care. The meta-analysis showed statistically significant differences in MI and AO interventions in patients with pain after surgery in six studies, with a large clinical effect (n = 124; SMD = −0.84; 95% CI: −1.47 to −0.21). In patients with chronic pain, results showed statistically significant differences in MI and AO interventions in three studies, with a large clinical effect (n = 83; SMD = −2.14; 95% CI: −3.81 to −0.47). Risk of bias, imprecision and inconsistency decreased the GRADE level of evidence.Conclusions: There was very low-quality evidence regarding the effects of movement representation techniques intervention (AO and MI) on pain intensity in patients with post-surgical pain. In addition, there was very low-quality evidence regarding the effects of MI and AO interventions on chronic pain. Significance: Movement representation techniques in combination with usual care are capable of producing a decrease in pain intensity compared with conventional treatment, in both post-surgical and chronic pain. However, the very low-quality evidence found regarding these techniques showed that more research is needed for their application in a clinical context. K E Y W O R D Saction observation, chronic pain, motor imagery, movement representation techniques, musculoskeletal pain

Assessment and Brain Training of Patients Experiencing Head and Facial Pain with a Distortion of Orofacial Somatorepresentation: A Narrative Review

“…The visual mirror feedback therapy consists of observing the movement that is being performed with a focus over motor cues, such as "pay attention to the jaw movement to the right". There is evidence of the effects of this techniques for pain reduction, improving range of movement and strength [167][168][169][170].…”

Pain relief by movement representation strategies: An umbrella and mapping review with meta‐meta‐analysis of motor imagery, action observation and mirror therapy

“…The qualitative synthesis included 10 systematic reviews (Boesch et al, 2016;Bowering et al, 2013;Duong et al, 2018;Méndez-Rebolledo et al, 2017;Suso-Martí et al, 2020;Thieme et al, 2016;Thieme et al, 2018;Wittkopf et al, 2018;Yang et al, 2018;Yap & Lim, 2019), which contained 86 primary articles, 31 of which were included in 33 meta-analyses. Figure 1 shows the flow chart indicating the search strategy.…”

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“…Furthermore, some dancers will dance with their eyes closed, a method that enhances one's focus on the proprioceptive cues and integration of body awareness. Such strategies of motor learning have also shown some promise in neurorehabilitation for conditions such as Parkinson's disease (Caligiore et al, 2017), post stroke (Emerson et al, 2018), and are gaining momentum in people with persistent pain (Thieme et al, 2016;Wallwork et al, 2016;Suso-Martí et al, 2020) to reduce movementrelated disability.…”