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Graded Motor Imagery: Retrain the Brain to Decrease
Pain, Improve Motion and Function

Presented by Susan Stralka

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This course will be retired and no longer available as of December 31, 2024. Please complete the course by December 31, 2024, to receive credit. Graded Motor Imagery (GMI) and Mirror Therapy are emerging therapeutic strategies for both musculoskeletal and neurovascular consequences of injury. They integrate established principles of graded exposure and response prevention with the current theories in the neuroscience of pain and neuroplasticity. Graded Motor Imagery is a sequential process consisting of laterality training, imagery and mirror therapy. These techniques are delivered sequentially but require a flexible approach from the patient and clinician to move forwards, backwards and sideways in the treatment process to suit the individual, which targets the synapsis in the brain. These strategies are supported by new evidence, showing the cortical reorganization of the brain improving with Graded Motor Imagery. The interplay between the brain and the body is most important to understand and to assist in designing a rehabilitation technique that can “rewire the brain”. This lecture will present a model to understand the role of the brain and ways to use a “top down’’ treatment program to treat the changes that occur in the brain.

Meet your instructor

Susan Stralka

Susan W. Stralka, PT, DPT, MS, is a licensed physical therapist with many years of experience treating both musculoskeletal and neurovascular consequences of injury. She earned her bachelor's degree, master's degree, and Doctorate in Physical Therapy from The University of Tennessee Health Sciences Center in Memphis,…

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Chapters & learning objectives

Brain Changes

1. Brain Changes

Recognize neuroplasticity as a potential target for therapist to utilize in developing treatment for persistent pain. Outline the events showing that pain is an output of the brain. Correlate Melzack’s Neuromatrix when developing therapeutic goals.

Pain Mechanisms

2. Pain Mechanisms

Critique why pain is a complex process. Compare the pain mechanisms with clinical symptoms. Identify the ways to differentiate allodynia from hyperalgesia.

Bio-Psycho-Social Approach

3. Bio-Psycho-Social Approach

Explain the Bio-psycho-social approach involved in patient care. Compare the bio-psycho –social approach with the biological medical approach.

Concepts of Graded Motor Imagery

4. Concepts of Graded Motor Imagery

Identify the practical application of Graded Motor Imagery for various neurovascular and musculoskeletal injuries. Integrate the use of laterality or right/left identification, imagery, and mirror therapy into plan for retraining the brain. Verify the progression of moving from laterality to imagery.

Clinical Evidence

5. Clinical Evidence

Connect the clinical evidence of utilization of Graded Motor Imagery in retraining the brain. Recognize the clinical patterns of central sensitization. Analyze why Graded Motor Imagery is a therapeutic model to use for treating Phantom Limb Pain.

Clinical application for Neuro and Ortho patients

6. Clinical application for Neuro and Ortho patients

Describe why therapeutic neuroscience education is necessary in understanding a patient’s diagnosis. Compare top down education to bottom up education in achieving therapeutic goals.