• Ferran Cuenca-Martínez, Álvaro Reina-Varona, Juan Castillo-García, Roy La Touche, Santiago Angulo-Díaz-Parreño, and Luis Suso-Martí.
• Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.
• Eur J Pain. 2022 Feb 1; 26 (2): 284-309.

ObjectiveTo develop a mapping and umbrella review with a meta-meta-analysis (MMA) to critically evaluate the current evidence of motor imagery (MI), action observation and mirror therapy (MT) on pain intensity.MethodsThe study involved a systematic search of PubMed, PEDro, Scielo, EBSCO and Google Scholar.ResultsTen systematic reviews were included in the qualitative synthesis, 70% of which showed high methodological quality. Three reviews found a significant reduction in chronic musculoskeletal pain as the result of applying movement representation methods (MRM) plus usual-care (UC), with a large clinical effect (standardized mean difference [SMD] of -1.47; 95% CI -2.05 to -0.88; heterogeneity Q = 1.66; p = 0.44; I2  = 0%). However, two reviews showed no statistically significant reduction in acute and postsurgical pain as a result of applying MI plus UC. Four reviews showed no significant reduction in phantom limb pain (PLP) as a result of applying MT plus UC interventions. In four reviews, the MMA showed a significant reduction in complex regional pain syndrome (CRPS) as a result of applying MT plus UC, with a large clinical effect (SMD -1.27; 95% CI -1.87 to -0.67; heterogeneity Q = 3.95; p = 0.27; I2  = 24%). In two reviews, the MMA showed no significant differences in poststroke pain as a result of applying MT plus UC.ConclusionResults show that MRM could be effective for chronic musculoskeletal pain, with low to moderate-quality evidence. The results also show a reduction in pain intensity through MT interventions in patients with CRPS, although these results were not found in patients with PLP or poststroke pain.SignificanceThis umbrella review analysed systematic reviews evaluating movement representation techniques, with the aim of synthesizing the available evidence regarding motor imagery, action observation and mirror therapy on pain. The results provide relevant information about the potential clinical use of movement representation techniques in different types of patients with painful conditions.© 2021 European Pain Federation - EFIC®.

10 keywords...

hide…