Added effect of graded motor imagery to rehabilitation protocol for post-operative rotator cuff repair on pain, kinesiophobia, functions, and mobility-a randomized controlled pilot study.

Abstract

Severe grade rotator cuff injuries require surgery, but post-surgical pain and kinesiophobia can hinder rehabilitation. Graded Motor Imagery (GMI) aids to reduce these challenges through its three phases. However, there is less supporting evidence on the effect of GMI in post-surgical shoulder rehabilitation cases. To explore the added effect of GMI combined with conventional rehabilitation on pain, kinesiophobia, functions, and joint mobility following rotator cuff repair. 16 participants (aged 45-60) were randomly assigned to experimental (GMI + conventional rehabilitation) and control (conventional rehabilitation) groups. Primary outcome was pain (NPRS), and secondary outcomes were kinesiophobia (TSK), shoulder function (Quick DASH), and mobility (goniometer). Assessments occurred pre-operatively, 3rd post-op day pre-rehab, and post---rehab after 3 weeks. Phase 1 GMI began post-immobilization (day 3) in the hospital; Phases 2 and 3 followed on alternate days after discharge via home or OPD sessions according to the convenience of the patient. At 3 weeks, experimental group showed improvements across all measures, pain (<i>d</i> = -2.55; <i>P</i> = .002), kinesiophobia (<i>d</i> = -3.18; <i>P</i> = .001), functional status (<i>d</i> = -1.71; <i>P</i> = .007) and shoulder mobility flexion (<i>d</i> = 4.65; <i>P</i> = .0001), abduction (<i>d</i> = 6.43; <i>P</i> = .0001), Internal (<i>d</i> = 1.48; <i>P</i> = .012) and External rotation (<i>d</i> = 2.71; <i>P</i> = .002). Adding GMI to conventional post-surgical rehabilitation may help to reduce pain and kinesiophobia, thereby improving functional outcomes and mobility following rotator cuff repair.