Update on the effects of graded motor imagery and mirror therapy on complex regional pain syndrome type 1: A systematic review

Abstract

Graded motor imagery (GMI) and mirror therapy (MT) is thought to improve pain in patients with complex regional pain syndrome (CRPS) types 1 and 2. However, the evidence is limited and analysis are not independent between types of CRPS. The purpose of this review was to analyze the effects of GMI and MT on pain in independent groups of patients with CRPS types 1 and 2. Searches for literature published between 1990 and 2016 were conducted in databases. Randomized controlled trials that compared GMI or MT with other treatments for CRPS types 1 and 2 were included. Six articles met the inclusion criteria and were classified from moderate to high quality. The total sample was composed of 171 participants with CRPS type 1. Three studies presented GMI with 3 components and three studies only used the MT. The studies were heterogeneous in terms of sample size and the disorders that triggered CRPS type 1. There were no trials that included participants with CRPS type 2. GMI and MT can improve pain in patients with CRPS type 1; however, there is not sufficient evidence to recommend these therapies over other treatments given the small size and heterogeneity of the studied population.

Bodily Sensory Inputs and Anomalous Bodily Experiences in Complex Regional Pain Syndrome: Evaluation of the Potential Effects of Sound Feedback

“…This may have relevance to rehabilitation, particularly where lower limb CRPS patients perceive the limbs as heavy and weak, which may contribute to the gait impairment that is often observed in CRPS population (Galer et al, 1999). Visual manipulation is established in CRPS treatment in mirror visual feedback therapy (Méndez-Rebolledo et al, 2016), and in therapies using prisms (Moseley et al, 2013). There is potential to combine manipulation of auditory and visual stimuli in the treatment of CRPS and future work would be needed to discover if this is practical, and offers the potential for a synergistic effect.…”

Efectos del tratamiento multimodal en pacientes con Síndrome de Dolor Regional Complejo tipo 1 con al menos 6 meses de evolución: Un estudio descriptivo

“…Este factor también pudo haber incidido en la intensidad del dolor y funcionalidad al momento del ingreso. Ambas terapias son un pilar fundamental en la mejoría de la función en pacientes con SDRC (14,15) sobre todo en pacientes con SDRC 1 de evolución prolongada (> a 12 meses) (14).…”

“…Basado en las recomendaciones de las revisiones y sistemáticas y guías clínicas de práctica clínica, el manejo terapéutico del SDRC 1, debe incluir intervenciones interdisciplinarias. El objetivo principal es restaurar la funcionalidad, a través de educación y rehabilitación física con movilización gradual de la extremidad, hidroterapia, terapia de espejos e imaginería motora (6,(14)(15)(16). Se debe abordar además aspectos psicológicos y el alivio del dolor (5,13).…”

"Non-Pharmacological Interventions for Chronic Pain and Depression: any Possible Applications of Multisensory Feedback Approaches Based on Body Representation? "

“…A study using mirror therapy has shown how this type of visual feedback is effective in reducing pain and enhance motor functionality in the affected limb of stroke patients with complex regional pain syndrome (CRPS) type 1 [40]. A recent review has reported how both graded motor imagery and mirror therapy can improve pain in CPRS type 1 patients, although the authors pointed out that results are not conclusive [41].…”