Graded Motor Imagery (GMI): Stage 1 Laterality exercises
Information for patients from the Outpatient Therapy Service
Graded Motor Imagery exercises are not suitable for patients who have dyslexia or for children.
Laterality exercises are the first of a three stage program called Graded Motor Imagery. For more information, ask your therapist for a copy of the Graded Motor Imagery (GMI) leaflet.
This leaflet explains the following.
How laterality exercises can help with your pain.
What the exercises involve.
How and when to do the exercises.
How you can help yourself to get the most out of the exercises.
We hope this leaflet answers some of the questions you may have. If you have any further questions or concerns, please speak to your therapist.
Why use laterality exercises?
Laterality exercises can be thought of as a ‘Train the Brain’ technique.
Laterality is our ability to recognise left and right sides. We look at our own limbs or other people’s limbs and try to identify which is the left side or which is the right side. To do this, we use the area of our brain involved in movement planning, not movement execution (actually moving). It is thought that the movement planning area of our brain is less likely to be sensitised and send pain messages. This is the back door.
What are laterality exercises?
A laterality exercise is:
taking time to look at arms / hands or legs / feet;
to identify which is the left side and which is the right side.
It sounds very simple but it is often quite difficult.
How I do laterality exercises?
There are a number of ways to do these exercises. Find the way that appeals to you the most. You may need some practical help with some of the exercises. Here are some suggestions.
Look through magazines and pick out (or circle) all the left or right hands / feet. Cut out lots of pictures of hands / feet in different positions and situations. Make a scrap book or ring binder of these pictures and use it as an exercise book. Make sure that you leave one corner of each image unstuck, so that you can mark underneath if it is left or right.
Once you have between 30 and 50 images, you can time yourself to see if your speed of recognition is improving.
There are orientation apps available to improve your left / right discrimination. Search for ‘Laterality App’ on your smart device.
Take photographs (with permission) of other people’s hands in various positions. Include them doing tasks, such as using a screw driver or peeling a potato. Use your imagination. The more pictures the better. Get someone who is good at laterality to mark on the back of the photos which are left and which are right.
Use the photos (or clippings) and put into two piles for left and right. Check the back and see how accurate you were.
Take pictures of left and right sides in the same position, for example in pairs. Get the photos developed so you can shuffle the pairs to play snap or play a memory game. Lay them down flat and turn them over in twos, to try to make a left and right pair.
When should I do the exercises?
If you are following the structured Graded Motor Imagery program, practise these exercises for 5 minutes in every waking hour for at least two weeks.
You can follow the less structured program, as long as you practice a number of times every day until your ability improves.
Can I do anything else to help me get the most out of these exercises?
Yes. Learn to relax before and during the exercises. For example, sit where you feel most comfortable, practice deep breathing, and relax your tense muscles.
Once you have practised and got better at the laterality exercises, it is important that you practice them in different contexts. For example:
Do the exercises in different environments. For example in different rooms, at the park, in waiting areas, or at a friend’s house.
Choose different times of day and during different moods.
Practice using different background music, such as slow and soothing or upbeat and bouncy.
Practice on your own and with others.
Make it as fun as possible. Invent your own games.
Stop exercising if you feel a continued increase in pain
Other suggestions
Keep a diary record that includes the following.
The date and time of day you exercise.
Your pain level, using the following scale: (none) 0 1 2 3 4 5 6 7 8 9 10 (worst)
Your mood when you exercise: happy? relaxed? OK? sad? angry? worried? tense?
Where you exercised (the environment): such as in a quiet room, at the park, at work
Comments about the exercise: for example what activity did you do? what was your score? have you improved? how difficult was the exercise?
Further information
If you have any further questions, please speak to your therapist.
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