Client buy-in: An essential consideration for graded motor imagery in hand therapy

Abstract

Study DesignThis is a cross-sectional survey research. IntroductionCurrent evidence provides efficacy of graded motor imagery (GMI) in chronic pain conditions but also reveals barriers to its implementation. Purpose of the StudyThe purpose of this study was to describe current utilization of GMI in hand therapy practice. MethodsSurvey tool, informed by literature and Revised Neurophysiology of Pain Questionnaire (NPQ) was electronically distributed to members of the American Society of Hand Therapists. Results132 therapists completed the survey. 65.2% reported they would always or very likely use GMI in clients with central sensitization, but no relationship between the likelihood of therapists using GMI to score achieved on the NPQ was found. Lack of patient buy-in, was the main barrier cited. “Sell it well” with pain neuroscience education the most cited strategy. DiscussionGMI is frequently used in clients with central sensitization but requires client buy-in. ConclusionsUnderstanding and explaining pain mechanism is essential for implementing GMI.