Background & Aims

Background: There are not previous studies that have analyzed the long-term effects of graded motor imagery (GMI) in chronic shoulder pain.
Purpose: The aim of this study was to assess at six months and one-year follow-up the effect of GMI on the affective and clinical outcomes in patients with chronic shoulder pain.

Methods

Methods: A pre-post observational study was conducted based on STROBE guidelines. Between October 2018 and April 2022, one hundred forty-eight patients with chronic shoulder pain were included (aged over 60 years with shoulder pain secondary to tendinopathy, and pain duration of at least six months). All participants received a six-week GMI program in addition to usual care. The primary outcome assessed was pain intensity using Visual Analog Scale (VAS), the secondary outcomes were fear of movement with the Tampa Scale of Kinesiophobia (TSK), catastrophization with the Pain Catastrophization Scale (PCS), shoulder flexion active range of motion (AROM) with a goniometer, and central sensitization with the Central Sensitization Inventory (CSI). All outcomes were assessed at baseline, six months, and one-year follow-up.

Results

Results: The baseline CSI was 48.3 points, which indicates a higher level of CS. The mean duration of symptoms was 61.2 months. The most common type of shoulder condition was partial rotator cuff tear (57.5%). At six months of follow-up, the VAS showed a decrease of 3.2 cm (CI 95% 2.8 to 3.5; p <0.001), TSK showed a decrease 15.8 points (CI 95% 12.5 to 15.9; p <0.001), PCS showed a decrease 29.8 points (CI 95% 12.7 to 17.2; p<0.001), AROM showed an increase of 24.2 degrees (CI 95% 20.4 to 31.8; p <0.001), and CSI showed a decrease 12.7 (CI 95% 6.6 to 13.4; p <0.001). At one-year follow-up, the VAS showed a decrease of 3.3 cm (?2= 0.7; CI 95% 0.68 to 0.75; p < 0.001), TSK showed a decrease of 16.1 points (?2= 0.7; CI 95% 0.76 to 0.81; p < 0.001), PCS showed a decrease of 17.4 points (?2= 0.8; CI 95% 0.78 to 0.83; p < 0.001), AROM showed an increase of 29.9 degrees (?2= 0.3; CI 95% 0.32 to 0.45; p < 0.001), and CSI showed a decrease of 17.9 (?2= 0.3; CI 95% 0.32 to 0.41; p < 0.001).

Conclusions

At medium and long-term follow-up, the patients with chronic shoulder pain who received the GMI program showed a clinically and statistically significant change for all outcomes assessed. Our findings support the use of GMI in addition to usual care, therefore, will be a validate alternative for the treatment of patients with chronic shoulder pain. Finally, further studies, including clinical trials, are needed to confirm our findings.

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Presenting Author

Felipe Araya-Quintanilla

Poster Authors

Felipe Araya-Quintanilla, BPT, MsC. PhD

PT, MSc, PhD

Escuela de Kinesiología, Facultad de Odontología y Ciencias de la Rehabilitación, Universidad San Se

Lead Author

Héctor Gutiérrez-Espinoza

PT

Universidad de las Americas, Quito. Ecuador

Lead Author

Guillermo Mendez-Rebolledo

PT

Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Talca 110231, Chile.

Lead Author

Iván Cuyul-Vásquez

PT

Dpto. de Procesos Terapéuticos, Facultad de Cs. de la salud. Universidad Católica de Temuco, Chile

Lead Author

Iván Cavero-Redondo

PhD

Universidad de Castilla - La Mancha, Spain

Lead Author

Celia Álvarez-Bueno

PhD

Universidad de Castilla - La Mancha, Spain

Lead Author

Dimitrios Stasinopoulos

PhD

University of West Attica, Athens, Greece

Lead Author

Topics

  • Models: Musculoskeletal