Graded motor imagery and its phases for individuals with phantom limb pain following amputation: A scoping review.
Kierra Jean Falbo, Hannah Phelan, Dawn Hackman and 2 others
PMID 37849299WHAT IT FOUND
Most research on graded motor imagery for phantom limb pain tests only mirror therapy, not the full three-phase protocol.
Dosing varies wildly with no standard best practice, and evidence for the complete three-phase approach is extremely limited.
Key findings
01The vast majority of included studies used only one phase of graded motor imagery, predominantly mirror therapy, rather than the full three-phase protocol.
02Treatment protocols showed significant inconsistency in dosing, frequency, and duration, with no established standard of care.
03While 89% of works reported positive results for pain reduction, the review explicitly states it did not analyze effectiveness and found insufficient evidence to support or refute the three-phase protocol's superiority.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The review included grey literature and conference abstracts, which may lack detailed methodological reporting. Most studies had small sample sizes (median 10 participants). There was a heavy skew towards male participants, limiting generalizability to female patients. The review did not assess the quality or risk of bias of the included studies, as is standard for scoping reviews. Race and ethnicity data were largely unreported, limiting understanding of cultural factors in pain perception.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not interpret the 89% positive result rate as proof that graded motor imagery works. This figure reflects the number of papers reporting a positive outcome, not a pooled effect size, and the review explicitly states it did not analyze effectiveness. Furthermore, most of these positive results came from mirror therapy alone, not the full three-phase protocol.