Guided imagery for musculoskeletal pain: a systematic review.
ABSTRACT The objective of this systematic review was to assess the effectiveness of guided imagery (GI) as a treatment option for musculoskeletal pain (MSP).
Six databases were searched from their inception to May 2010. All controlled clinical trials were considered, if they investigated GI in patients with any MSP in any anatomic location and if they assessed pain as an outcome measure. Trials of motor imagery were excluded. The selection of studies, data extraction, and validation were performed independently by 2 reviewers.
Nine randomized clinical trials (RCTs) met the inclusion criteria. Their methodologic quality ranged between 1 and 3 on the Jadad scale. Eight RCTs suggested that GI leads to a significant reduction of MSP. One RCT indicated no change in MSP in comparison with usual care.
It is concluded that there are too few rigorous RCTs testing the effectiveness of GI in the management of MSP. Therefore, the evidence that GI alleviates MSP is encouraging but inconclusive.
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ABSTRACT: This review-with a handy at-a-glance guide-examines 8 modalities, the level of evidence behind them, and the adverse effects you'll need to keep in mind.
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ABSTRACT: Chronic low back pain (LBP) and neck pain (NP) are highly prevalent conditions resulting in high economic costs. Treatment guidelines recommend relaxation techniques, such as progressive muscle relaxation, as adjuvant therapies. Self-care interventions could have the potential to reduce costs in the health care system, but their effectiveness, especially in a usual care setting, is unclear. The aim of these two pragmatic randomized studies is to evaluate whether an additional app-delivered relaxation is more effective in the reduction of chronic LBP or NP than usual care alone.Methods/design: Each pragmatic randomized two-armed study aims to include a total of 220 patients aged 18 to 65 years with chronic (>12 weeks) LBP or NP and an average pain intensity of >= 4 on a numeric rating scale (NRS) in the 7 days before recruitment. The participants will be randomized into an intervention and a usual care group. The intervention group will be instructed to practice one of these 3 relaxation techniques on at least 5 days/week for 15 minutes/day over a period of 6 months starting on the day of randomization: autogenic training, mindfulness meditation, or guided imagery. Instructions and exercises will be provided using a smartphone app, baseline information will be collected using paper and pencil. Follow-up information (daily, weekly, and after 3 and 6 months) will be collected using electronic diaries and questionnaires included in the app.The primary outcome measure will be the mean LBP or NP intensity during the first 3 months of intervention based on daily pain intensity measurements on a NRS (0 = no pain, 10 = worst possible pain). The secondary outcome parameters will include the mean pain intensity during the first 6 months after randomization based on daily measurements, the mean pain intensity measured weekly as the average pain intensity of the previous 7 days over 3 and 6 months, pain acceptance, 'LBP- and NP-related' stress, sick leave days, pain medication intake, adherence, suspected adverse reaction, and serious adverse events. The designed studies reflect a usual self-care setting and will provide evidence on a pragmatic self-care intervention that is easy to combine with care provided by medical professionals.Trial registration: ClinicalTrials.gov identifier Relaxback NCT02019498, Relaxneck NCT02019134 registered on 18 December 2013.Trials 12/2014; 15(1):490. DOI:10.1186/1745-6215-15-490 · 2.12 Impact Factor