*NEW* Graded Motor Imagery handbook A handbook arising from the last 15 years of neuroscience, clinical trials and clinical reasoning science is here for both clinicians and pain sufferers. Lorimer Moseley, David Butler, Timothy Beames, Thomas Giles

Graded motor imagery (GMI) is a sequential process of rehabilitation where the therapeutic targets are synapses in the brain (it is essentially a series of brain exercises). It is made up of the following activities: laterality reconstruction, motor imagery, mirror therapy. It could also be taken into active movement with the targets still synaptic.

The process is best if carried out in consultation with a clinician who understands GMI and can help you set out an appropriate programme.

Laterality reconstruction	Motor imagery	Mirror therapy

"Movement and pain are close allies: they are both used by the brain to protect the body, they both depend on an evaluation of the current need for movement, they both depend on the brain's maps of the body. Movement and pain are such good friends that pain makes one move differently, and movement affects ones pain. In fact, in some chronic pain states, even thinking about movement hurts and increases swelling (Thinking about movement hurts: the effect of motor imagery on pain and swelling in people with chronic arm pain. Moseley GL et al. Arthritis Rheum. 2008 May 15;59(5):623-31.)."

"The brain is wonderfully adaptable. It is also a fierce protector of the body. Graded motor imagery aims to exploit the brain's huge capacity to adapt without setting off its more protective side. By getting under the radar of a protective system, graded motor imagery has been shown to offer substantial gains in pain and disability for people with pathological pain syndromes such as complex regional pain syndrome and phantom limb pain. It is indeed an exciting new area with much promise - scientists across the world are now investigating whether graded motor imagery has a more general role in rehabilitation and performance."

Dr. Lorimer Moseley, Clinical Neuroscientist