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Saturday, November 17, 2012

Graded Motor Imagery: Chronic Pain Tool and Loss of Body Sensation Tool

I would like to introduce a fascinating topic called "Graded Motor Imagery". I have several patients who have used the technique to help with their pain or nerve syndromes, several patients who have been exposed to it, and many more that I will now expose and emphasize as part of their pain treatment. The Noi Group has a well organized website to let you get started. The photos below are part of the process of laterality--recognizing which side of the body a photo is taken. Amazingly, in many nerve injuries, we lose the ability of our nervous system to process this.  I hope the videos, websites, and photos are a good enough start to help you or a loved one in the overwhelming process of healing when all seems to be losted. It is many times that the spouse or friend must help the patient take the initial steps towards healing. This is a process that can be done alone, or helped tremendously with another.

These photos are part of the first and very vital steps in Graded Motor Imagery called Laterality. The links above contain the website to login and begin the process now. The patient is asked to identify which foot is being shown, and later asked to imagine their foot in that position.

David Butler is a physiotherapist in Australia. After you hear this 40 minute presentation broken in 4 parts, you will want to have him over and make him your best friend. What a character!! I believe the main parts of this process are adequately introduced. 

Here a patient with complex regional pain syndrome explains her use of mirror therapy in a touching manner.


  1. Hi Rich,
    Also add Lorimer Moseley's website to your reference list. Lorimer is a co-author of The Graded Motor Imagery Handbook. He has free access to many articles in PDF format on the website.
    Nancy Bryan, PT

  2. I have a co-worker that is working with a patient of yours and I was surprised and pleased that you were using GMI with her. I love that as a physician, you are utilizing this. I use it often with patients with CRPS, as well as other painful presentations. Do you provide the cards at charge or freely distribute? Looking for a more affordable way to provide these to patients. Thanks again for being on the forefront of pain science!
    Tianna Meriage-Reiter, PT
    Alameda, CA

  3. Tianna, Thanks for your comment. I was given 49 flashcards from a patient, and I just make copies at no charge. It is reasonable however, due to the ink cost of color copies, to charge a nominal fee. Dr Rich Blake

  4. Hi!
    Just as a thought - you could get patients to make their own flashcards by taking pictures of family members' hands/feet etc. That could also help to be more engaged in their own treatment.
    Ethel Hili
    Clinical Specialist Physio (Chronic Pain)

    1. Thank you Ethel, This is how I learn and I will apply the principle with my patients. Dr Rich Blake


Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.