Abstract

Objective: Mirror therapy (MT) is an important technique in the rehabilitation of patients who experience pain and decreased function. However, there are limited research studies on its application and effectiveness in shoulder pathologies, especially when it is applied as a part of graded motor imagery (GMI). The present study aims to highlight a novel therapeutic approach for the treatment of shoulder painful pathologies, using an innovative Mirror Therapy (Fekos Mirror Therapy) method in combination with motor imagery.
Purpose: To investigate the efficacy of a novel MT included in an aggressive GMI protocol regarding pain reduction and range of motion (active shoulder flexion) restoration in patients with painful shoulder conditions.
Methods: A novel GMI programme (Implicit Motor Imagery, Explicit Motor Imagery, and Fekos Mirror Therapy) was applied in five female patients (age: 18 -77 years) with symptoms of pain and decreased active range of motion for more than three months, for four treatment sessions (one-hour sessions). Variables assessed in each session included the active shoulder flexion (SpineCor®), pain (VAS), accuracy and response time in laterality recognition of the body (Recognise Online™) and the motor imagery ability (the Kinesthetic and Visual Imagery Questionnaire/KVIQ - 10).
Results: KVIQ-10 showed improvement in the motor imagery ability for the two sub-scales. The active shoulder flexion was increased and the pain decreased in all five patients, but the last one with fluctuation. According to Recognise Online™ programme, only one patient scored higher response times and lower accuracy for the affected limb compared to the healthy one.
Conclusions: Central nervous system damage is present in chronic musculoskeletal patients, and GMI protocol containing Fekos Mirror Therapy technique may have a positive effect on the recovery of painful joint functional capacities. This method is in need of further implementation in randomized control studies for the confirmation of its efficacy.

Keywords: Mirror therapy; Shoulder; Graded motor imagery; Motor imagery; Pain; Active range of motion; Implicit motor imagery