Progressive kinematic images may improve outcomes in patients with post-traumatic elbow stiffness

September 15, 2022

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Published results show that graded kinematic images may improve the function, active range of motion of the elbow, pain and fear of movement-related pain, and muscle strength in patients with post-traumatic elbow stiffness.

The present study provides evidence that adding [graded motor imagery (GMI)] A postoperative elbow rehabilitation program may reduce pain intensity and pain-related fear of movement and improve functional level in patients with post-traumatic elbow stiffness.”


After 6 weeks of the post-traumatic elbow stiffness intervention, results showed that 80% of patients on the gradient kinematic imaging program and 72% of patients on the structured exercise program reported that they improved significantly. Data were derived from Birinci T, et al. J Shoulder Elbow Surg. 2022; doi: 10.1016/j.jse.2022.05.031.

The researchers separated 50 patients with post-traumatic elbow stiffness into a GMI program (n = 25) which consisted of right/left discrimination, motor imagery and mirror therapy twice a week for 6 weeks or a structured exercise program (n = 25) which consisted of a combination of Movement, stretching and strengthening exercises twice a week for 6 weeks. The researchers reported that both groups also underwent a 6-week home exercise program. The researchers assessed patients at baseline, at the end of the 12-session treatment and at 6-week follow-up using the DASH score as the primary outcome and active range of motion, VAS score, Tampa phobic scale, elbow muscle strength and extensor strength, grip strength, and right/left discrimination. , and global classification of change as secondary outcomes.

Although both patients in GMI and the structured exercise intervention had significantly improved outcomes, the results showed a significant improvement in DASH scores after the 6-week intervention with a medium effect size in the GMI group versus the structured exercise group. After the 6-week intervention, the researchers found that 80% of patients in the GMI group and 72% of patients in the structured exercise group reported significant improvement. The authors note that the GMI group also achieved significant results with a medium-to-large effect size of active range of motion for elbow flexion, VAS activity, Tampa phobic scale, and strength of the elbow flexors and elbow extension muscles.

“The GMI Cognitive-Motor Intervention Program is an effective method in post-traumatic elbow stiffness rehabilitation to counteract the adverse effects of immobility and the fear of movement-related pain without stressing the affected side,” the authors wrote. “Future research could investigate the effectiveness of alternative intervention programs focused on the cognitive and musculoskeletal system in post-traumatic stiffness of the upper extremity.”