Immediate effects of mirror therapy in patients with shoulder pain and decreased range of motion

Publication date: Available online 5 May 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Adriaan Louw, Emilio J. Puentedura, Dave Reese, Paula Parker, Terra Miller, Paul Mintken
ObjectiveTo determine the effects of a brief single component of the graded motor imagery (GMI) sequence (mirror therapy) on active range of motion (AROM), pain, fear-avoidance and pain catastrophization in patients with shoulder pain.DesignSingle-blind case seriesSettingThree outpatient physical therapy clinicsParticipantsPatients with shoulder pain and limited AROM.InterventionsPatients moved their unaffected shoulder through comfortable AROM in front of a mirror so that it appeared that they were moving their affected shoulder.Main Outcome Measure(s)We measured pain, pain catastrophization, fear-avoidance and AROM in 69 consecutive patients with shoulder pain and limited AROM before and immediately after mirror therapy.ResultsThere were significant differences in self-reported pain (p=.014), Pain Catastrophization (p<.001), and the Tampa Scale of Kinesiophobia (p=.012) immediately after mirror therapy, although the means did not meet or exceed the minimal detectable change (MDC) for each outcome measure. There was a significant increase (mean = 14.5°) in affected shoulder flexion AROM immediately post-mirror therapy (p<0.001), which exceeded the MDC of 8 degrees.ConclusionsA brief mirror therapy intervention can result in statistically significant improvements in pain, pain catastrophization, fear-avoidance and shoulder flexion AROM in patients presenting with shoulder pain with limited AROM. The immediate changes may allow a quicker transition to multimodal treatment, including manual therapy and exercise in these patients. Further studies, including randomized controlled trials, are needed to investigate these findings and determine longer term effects.



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