Graded Motor Imagery

Explicit Motor Imagery

Explicit motor imagery is essentially thinking about moving without actually moving. Imagined movements can actually be hard work if you are in pain. This is most likely because 25 percent of the neurones in your brain are 'mirror neurones' and start firing when you think of moving or even watch someone else move (this is why you can feel exhausted after watching an action movie).

By imagining movements, you use similar brain areas as you would when you actually move. This is why sports people imagine an activity before they do it. It's exercising the brain before the rest of the body which is what you will be trying to do with the explicit motor imagery part of the GMI process.

There are many ways to go through this process but the most common way used in GMI is to imagine yourself moving rather than watching or imagining other people moving.

Everyday examples of Explicit Motor Imagery

When you get in a car to drive to a destination you imagine the course you will take
Girls in particular might imagine their make-up or hairstyle they will wear when they go out
Before a golfer putts, he or she will imagine the action and the ball going into the hole
Mountain climbers imagine themselves at the top of a mountain
Surgeons who imagine a surgical procedure first will have better mastery over their surgical performance

Tips, ideas and questions to consider

Where do I practice explicit motor imagery? At home, work, school, on the bus, in the bath?
Do I keep my eyes open or closed during motor imagery?
What position do I adopt during imagery? Sitting, standing, lying?
Should I start with the focus directly on my painful left arm, or is it best to start away from my left arm and on my right arm – gradually moving my focus to the painful area?
Do I think of myself moving (first person) or someone else moving (third person)?
How long should I perform imagery for and how many times a day?
What is the task complexity and intensity and how does it tie in with grading my exposure?
What words should the therapist use to describe or talk through the process?
What cues can be used to heighten the process? Sounds, memories, smells?
Should there be prior demonstration of the movement by another person (therapist, family member)?
Do I use relaxation or meditation in conjunction?
How much do I know about the changes in the brain that I can achieve with imagery?

Training tips

For more information see The Graded Motor Imagery Handbook, Moseley, Butler, Beames, Giles, Noigroup Publications, 2012.

Heighten your motor imagery experience with elements such as warmth, breezes, textures, smells, sounds, the weight of your limb, the space around you, the touch of your clothes, your environment (clinic, beach, park, home, school, work). Remember it is entirely what you imagine it to be!
This process can be quite potent and sometimes evoke fear and pain. Be wary of the power of the brain and take your time here.
It can also be useful to maintain your left/right discrimination exercises during this time.

Useful tools

Recognise online – Online program suitable for motor imagery tasks

Recognise apps - Available from the App Store and Google Play in 'Hands' and 'Feet'.

Recognise Flash Cards – 48 left and right images. Available in hands, feet, shoulders, backs and necks. Card games, reference list and instructions included.