Graded Motor Imagery (GMI): Stage 2 Explicit motor imagery or imagined movement
Information for patients from the Outpatient Therapy Service
Graded Motor Imagery exercises are not suitable for patients who have dyslexia or for children.
Explicit motor imagery is the second 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.
What explicit motor imagery is.
How explicit motor imagery can help you with your pain.
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.
What is explicit motor imagery?
Explicit motor imagery is imagining movement. When we imagine movement we activate both:
the movement planning; and
some of the movement execution area of our brain, without actually moving our body.
The purpose of this is to teach the sensitised areas of your brain that movement is not a threat. That you can move and not cause yourself pain.
To start with you may find you feel pain by imagining movement. With practice, it may be possible for you to activate the movement execution area of your brain without triggering a pain response.
Using explicit motor imagery:
Is a useful way of seeing the movement without the pain of the movement. This is helpful in the treatment of Complex Regional Pain Syndrome (CRPS), where the real movement is too sensitive or painful to complete.
It can also help prepare your body for real movement, by preparing your brain first.
What are explicit motor imagery exercises?
Explicit motor imagery exercises imagine movement without actually moving. It sounds very simple but is often quite difficult, especially if you have Complex Regional Pain Syndrome (CRPS).
Examples of explicit motor imagery
Athletes rehearsing a performance. For example, a dart thrower visualising their throw or a sprinter visualising their push off from the starting block.
Visualising your journey to work or to the supermarket, before getting into your car.
Therapists visualising the exercises they want to give patients, before prescribing them.
A chef visualising how to prepare and cook a dish, before starting.
How do you do explicit motor imagery?
There are a number of ways to do these exercises. Find the way that appeals to you the most. Here is a suggestion:
Visualise your limb (arm or leg) stationary (not moving). Try to imagine everything about your hand; its position, can you feel a breeze, the feeling of the surface being rested on.
Try to imagine your limb moving into certain positions. For example, making and releasing a fist.
Imagine your limb completing an activity. For example, picking up a cup of water and bringing it to your mouth to drink, and returning the cup to the table.
Remember, you are imagining these movements, so keep your limb stationary during each step.
Training tips
Imagine GMI as a staircase. If you have moved on to explicit motor imagery but this is too painful, go back to the laterality exercises. If you have not been prescribed these, speak to your therapist.
Aim to do explicit motor imagery exercises for 1 to 2 hours a day, for 2 weeks. This time can be split to fit into your daily routine. To start with, you may only be able to manage 30 minutes a day. With practice you can build-up to 1 to 2 hours a day.
It is useful to start explicit motor imagery at home in a quiet place, where you can concentrate. You will be able to progress to a more disruptive environment (for example at work) as you gain confidence.
Do the exercises at different times of the day and during different moods.
Make sure you are comfortable and relaxed. It may be useful to start your exercises while laying down. As you get more confident, move to sitting or standing.
Imagine what it would feel like to touch something with your hand. Can you smell anything? Is there a breeze? It is up to you to decide what you visualise the movement to be.
Take your time, do not rush.
You can visualise yourself or someone else performing the movement. This may reduce the chances of you feeling pain.
Try imagining the movement on your non-painful and your painful limb.
Continuing with the laterality exercises from step 1 can be useful.
Try online resources, such as apps and flashcards.
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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