Korean J Pain.  2023 Jul;36(3):369-381. 10.3344/kjp.23020.

The effect of graded motor imagery training on pain, functional performance, motor imagery skills, and kinesiophobia after total knee arthroplasty: randomized controlled trial

• Candiri B
• Talu B
• Guner E
• Ozen M

• KMID: 2544248
• DOI: http://doi.org/10.3344/kjp.23020

Abstract

Background
The aim was to investigate the effect of graded motor imagery (GMI) added to rehabilitation on pain, functional performance, motor imagery ability, and kinesiophobia in individuals with total knee arthroplasty (TKA).
Methods
Individuals scheduled for unilateral TKA were randomized to one of two groups: control (traditional rehabilitation, n = 9) and GMI (traditional rehabilitation + GMI, n = 9) groups. The primary outcome measures were the visual analogue scale and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Secondary outcome measures were knee range of motion, muscle strength, the timed up and go test, mental chronometer, Movement Imagery Questionnaire-3, lateralization performance, Central Sensitization Inventory, Pain Catastrophizing Scale, and Tampa Kinesiophobia Scale. Evaluations were made before and 6 weeks after surgery.
Results
Activity and resting pain were significantly reduced in the GMI group compared to the control group (P < 0.001 and P = 0.004, respectively). Movement Imagery Questionnaire-3 scores and accuracy of lateralization performance also showed significant improvement (P = 0.037 and P = 0.015, respectively). The Pain Catastrophizing Scale and Tampa Kinesiophobia Scale scores were also significantly decreased in the GMI group compared to the control group (P = 0.039 and P = 0.009, respectively). However, GMI did not differ significantly in WOMAC scores, range of motion, muscle strength, timed up and go test and Central Sensitization Inventory scores compared to the control group (P > 0.05).
Conclusions
GMI improved pain, motor imagery ability, pain catastrophizing, and kinesiophobia in the acute period after TKA.

Keyword

Arthroplasty, Replacement, Knee; Catastrophization; Central Nervous System Sensitization; Complementary Therapies; Graded Motor Imagery; Kinesiophobia; Pain; Pain Management; Rehabilitation

Figure

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  Fig. 1 Graded motor imagery program.

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  Fig. 2 (A) Knee flexion range of motion measurement. (B) Knee extension range of motion measurement. (C) Hand-held dynamometer. (D) Quadriceps femoris muscle force measurement.

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  Fig. 3 (A) Measurement of timed up and go test. (B) Measurement of mental chronometer performance.

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  Fig. 4 Design of the study (CONSORT flow diagram).

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