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J Back Musculoskelet Rehabil. 2017;30(3):441-449. doi: 10.3233/BMR-150500.

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

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Human Motor Control Laboratory, Department of Human Movement Sciences, Faculty of Health Sciences, Universidad de Talca, Talca, Chile.
Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Chile.
Department of Physiotherapy, University of Valencia, Valencia, Spain.
Department of Basic Biomedical Sciences, Faculty of Health Sciences, Universidad de Talca, Talca, Chile.


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.


Chronic pain; complex regional pain syndrome; mirror visual feedback; motor imagery; physiotherapy; reflex sympathetic dystrophy

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