ORLANDO, Fla. – Graded motor imagery is a new treatment for chronic pain states, including phantom limb pain. Kerstin Baun, MPH, OTR/L, presented two successful case studies using the therapy at the American Academy of Orthotists and Prosthetists Annual Meeting and Scientific Symposium.

The three-phase program incorporates left/right discrimination, explicit motor imagery and mirror therapy.

“Research over the past 2 decades has shown that chronic pain leads to changes in the central nervous system, and that is correlated with phantom pain. Performing graded motor imagery can reverse those changes and thereby decrease phantom pain,” Baun, who is from Advanced Arm Dynamics, said here.  

In right/left discrimination, patients view images of right or left hands or feet and decide which side they are looking at. Researchers look for accuracy and quick response times.

Kerstin Baun


“In explicit motor imagery, the patient is imagining their phantom limb in different positions, doing different kinds of movement and eventually functional activities. It activates motor regions, but to lesser degree than actual movement.”

Phase 3 involves mirror therapy, in which the patient uses a mirror to reflect the image of their intact limb, which helps the patient visualize the missing limb. Both case studies reduced or controlled their phantom pain using this method, Baun said.

“Graded motor imagery is a great tool to be able to use with your patient as part of a comprehensive prosthetic rehabilitation approach. Discuss phantom pain with your patients and figure out how you can best integrate what they may already be doing into a full graded motor imagery program,” Baun said.

For more information:

Baun K. Paper F11. Presented at: American Academy of Orthotists and Prosthetists Annual Meeting and Scientific Symposium. Feb. 20-23, 2013. Orlando, Fla.

Disclosure: Baun has no relevant financial disclosures.

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