Graded Motor Imagery in Elbow Limitation

NCT03969277 | Completed DMC

• 1 other identifier: 141001
• Study Type: interventional
• Target: 50
• Locations: 1 country
• Sites: 1

Brief Summary

This randomized-controlled trial aims to investigate the efficacy of Graded Motor Imagery (GMI) on function, pain, and range of motion (ROM) in patients with a posttraumatic stiff elbow.

Conditions

Elbow Fracture; Limitation, Mobility; Pain, Postoperative; Upper Extremity Problem

Keywords

Imagery; Mirror Neurons; Immobilization; Exercise; Rehabilitation

Outcome Measures

Primary Outcomes (1)

• Functional Status

  The functional status of the patients will be evaluated by The Disabilities of the Arm, Shoulder and Hand (DASH). It comprises 30 core questions and optional additional 8 questions that are scored on a 5-point Likert-type scale (no difficulty-unable). The cumulative DASH score is ranged from 0 to 100, where the higher scores indicate an increased degree of disability.

  After the six-week intervention

Secondary Outcomes (23)

• Pain Intensity

  Baseline

• Pain Intensity

  After the six-week intervention

• Pain Intensity

  6-week follow-up

• Active Range of Motion (AROM) Assessment

  Baseline

• Active Range of Motion (AROM) Assessment

  After the six-week intervention

Study Arms (2)

Graded Motor Imagery

EXPERIMENTAL

Each subject in the Graded Motor Imagery group will receive a treatment protocol consisting of Graded Motor Imagery, cold therapy, and home exercises.

Other: Graded Motor Imagery; Other: Home Exercise Program; Other: Cold Application

Standard Rehabilitation

ACTIVE COMPARATOR

Each subject in the Standard Rehabilitation group will receive a treatment protocol consisting of stretching and strengthening exercises, cold therapy, and home exercises.

Other: Standard Rehabilitation; Other: Home Exercise Program; Other: Cold Application

Interventions

Graded Motor Imagery OTHER

The first stage of GMI includes laterality reconstruction. Patients will view and determine if the various images of body parts to image portrays the right or left side. The second stage targets activation of the primary motor cortex by imagine moving the involved body part. The final stage involves that the patient watches the unaffected body part moving in a mirror to "trick" the brain into thinking the affected body part is actually moving in a pain-free way. This will be applied for 6 weeks.

Graded Motor Imagery

Standard Rehabilitation OTHER

Shoulder, elbow and wrist AROM exercises. Elbow flexion and extension, and wrist flexion and extension stretching exercises. Elbow and wrist strengthening exercises. Grip strengthening exercises. This will be applied for 6 weeks.

Standard Rehabilitation

Home Exercise Program OTHER

Proprioception exercises for the elbow. Scapulothoracic strengthening exercises. This will be applied for 6 weeks.

Graded Motor Imagery; Standard Rehabilitation

Cold Application OTHER

Cold application around the elbow joint for 15 minutes in every session.

Graded Motor Imagery; Standard Rehabilitation

Eligibility Criteria

• Age: 20 Years - 55 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Subjects will be included with
• Aged between 20 and 55 years
• Elbow fracture in the six months before the study
• Elbow limitation in flexion or extension
• Being a volunteer to participate
• Fractures should be managed with surgically
• The "Standardized Mini Mental Test" result must be at least 24 points

You may not qualify if:

• Malunion or Nonunion Fracture
• The occurrence of complex regional pain syndrome, peripheric nerve injury, heterotopic ossification, myositis ossification or post-traumatic ankylosing
• Non-healing wound or infection
• Previously received physiotherapy for elbow limitation
• Having any cardiovascular diseases, neurological disorders, rheumatic diseases or psychiatric diseases
• Could not adjust to the treatment
• Shoulder, elbow or wrist movement limitation in contralateral upper extremity or absence of limbs in the contralateral upper extremity
• Having severe visual loss

Sponsors & Collaborators

• Istanbul University - Cerrahpasa: lead

Study Sites (1)

Istanbul University-Cerrahpasa

Istanbul, Bakırkoy, 34147, Turkey (Türkiye)

Location

Related Publications (5)

• Mendez-Rebolledo G, Gatica-Rojas V, Torres-Cueco R, Albornoz-Verdugo M, Guzman-Munoz E. Update on the effects of graded motor imagery and mirror therapy on complex regional pain syndrome type 1: A systematic review. J Back Musculoskelet Rehabil. 2017;30(3):441-449. doi: 10.3233/BMR-150500.

  PMID: 27858687 BACKGROUND

• Sawyer EE, McDevitt AW, Louw A, Puentedura EJ, Mintken PE. Use of Pain Neuroscience Education, Tactile Discrimination, and Graded Motor Imagery in an Individual With Frozen Shoulder. J Orthop Sports Phys Ther. 2018 Mar;48(3):174-184. doi: 10.2519/jospt.2018.7716. Epub 2017 Dec 19.

  PMID: 29257926 BACKGROUND

• Dilek B, Ayhan C, Yagci G, Yakut Y. Effectiveness of the graded motor imagery to improve hand function in patients with distal radius fracture: A randomized controlled trial. J Hand Ther. 2018 Jan-Mar;31(1):2-9.e1. doi: 10.1016/j.jht.2017.09.004. Epub 2017 Nov 6.

  PMID: 29122370 BACKGROUND

• Priganc VW, Stralka SW. Graded motor imagery. J Hand Ther. 2011 Apr-Jun;24(2):164-8; quiz 169. doi: 10.1016/j.jht.2010.11.002. Epub 2011 Feb 9.

  PMID: 21306870 BACKGROUND

• Birinci T, Razak Ozdincler A, Altun S, Kural C. A structured exercise programme combined with proprioceptive neuromuscular facilitation stretching or static stretching in posttraumatic stiffness of the elbow: a randomized controlled trial. Clin Rehabil. 2019 Feb;33(2):241-252. doi: 10.1177/0269215518802886. Epub 2018 Oct 10.

  PMID: 30304958 BACKGROUND

Related Links

• Graded Motor Imagery

MeSH Terms

Conditions

Elbow Fractures; Mobility Limitation; Pain, Postoperative; Motor Activity

Condition Hierarchy (Ancestors)

Elbow Injuries; Arm Injuries; Wounds and Injuries; Fractures, Bone; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Postoperative Complications; Pathologic Processes; Pain; Neurologic Manifestations; Behavior

Study Officials

• Tansu Birinci, MSc

  Istanbul University - Cerrahpasa

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: PT, MSc Research Assistant

Study Record Dates

• First Submitted: May 29, 2019
• First Posted: May 31, 2019
• Study Start: October 15, 2019
• Primary Completion: October 1, 2020
• Study Completion: June 30, 2021
• Last Updated: October 8, 2024

Record last verified: 2021-06

Locations

TU (1)