Using graded motor imagery for complex regional pain syndrome in clinical practice: Failure to improve pain

被引：83

作者：

Johnson, S. ^{[1
]}

Hall, J. ^{[2
]}

Barnett, S. ^{[1
]}

Draper, M. ^{[1
]}

Derbyshire, G. ^{[1
]}

Haynes, L. ^{[1
]}

Rooney, C. ^{[1
]}

Cameron, H. ^{[1
]}

Moseley, G. L. ^{[3
,4
]}

Williams, A. C. de C. ^{[5
]}

McCabe, C. ^{[2
,6
]}

Goebel, A. ^{[1
,7
]}

机构：

[1] Walton Ctr NHS Fdn Trust, Liverpool L9 7LJ, Merseyside, England

[2] Royal Natl Hosp Rheumat Dis, Bath BA1 1RL, Avon, England

[3] Univ S Australia, Sansom Inst Hlth Res, Adelaide, SA 5001, Australia

[4] Neurosci Res Australia, Sydney, NSW, Australia

[5] UCL, Res Dept Clin Educ & Hlth Psychol, London, England

[6] Univ W England, Bristol BS16 1QY, Avon, England

[7] Univ Liverpool, Liverpool L69 3BX, Merseyside, England

来源：

EUROPEAN JOURNAL OF PAIN | 2012年 / 16卷 / 04期

基金：

英国医学研究理事会;

关键词：

MIRROR VISUAL FEEDBACK; VALIDATION; TRIALS; STIMULATION; OUTCOMES; PEOPLE; AREAS; LIMB;

D O I：

10.1002/j.1532-2149.2011.00064.x

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

Background: There is good evidence from studies conducted in a single-centre research setting for the efficacy of graded motor imagery (GMI) treatment, a complex physiotherapy intervention, to reduce pain in long-standing complex regional pain syndrome (CRPS). However, whether GMI is effective in clinical practice is not established. Aim: To establish whether GMI is effective in clinical practice. Methods: We undertook a prospective audit of GMI treatment at two UK centres with a special interest in the management of patients with CRPS. All patients received GMI, in conjunction with a range of other 'best practice' physical and psychological interventions. Results: The patients' average pain intensities did not improve with treatment [centre 1: n = 20, pre-post numeric rating scale (NRS) difference 0.6 [confidence interval (CI) -0.3 to 1.5]; centre 2: n = 12, pre-post NRS difference 0.2 (CI: -0.9 to 1.2)]. Patients at centre 1 reported significant functional improvement. Improved performance on left/right judgement replicated in both centres seen in the clinical trials. Conclusions: The failure of our real-world implementation of GMI suggests that better understanding of both the GMI methodology and its interaction with other treatment methods is required to ensure that GMI research results can be translated into clinical practice. Our results highlight challenges with the translation of complex interventions for chronic pain conditions into clinical practice.

引用

页码：550 / 561

页数：12