The Effect of Graded Motor Imagery on Pain and Function in Individuals With Knee Osteoarthritis

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Abstract
Objective: The aim of the study was to examine whether graded motor imagery was as effective as transcutaneous electrical nerve stimulation in improving pain and functionality in patients with knee osteoarthritis. Design: Forty-six patients with knee osteoarthritis were randomized (1:1) into the graded motor imagery and the transcutaneous electrical nerve stimulation groups. Both groups participated in home-based and functional exercises. A visual analog scale, the pressure pain threshold, range of motion, muscle strength, the Timed Up and Go Test, and the Western Ontario and McMaster Universities Osteoarthritis Index were evaluated at baseline, after 8 wks of treatment, and after a 6-wk follow-up period. Results: The within-group comparisons showed significant improvements in outcomes for both treatments. However, the difference between the groups was significant in favor of the graded motor imagery group in knee flexion range of motion, knee extensor muscle strength, and Western Ontario and McMaster Universities Osteoarthritis Index–pain and function parameters at the end of the treatment, and visual analog scale–activity, knee flexor muscle strength, and Western Ontario and McMaster Universities Osteoarthritis Index–stiffness values showed greater improvement in the graded motor imagery group compared with the transcutaneous electrical nerve stimulation group at the end of the 6-wk follow-up (for all, P < 0.05). Conclusions: Graded motor imagery seems to be a more effective adjuvant than transcutaneous electrical nerve stimulation. If applied in patients with knee osteoarthritis, pain and functional recovery improved, and results were maintained for up to 6 wks.

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