Frequently asked questions

Q. I didn’t know I had an access to Recognise online. Does it come with the purchase of the Graded Motor Imagery pack? How long does it take before I receive the package?
A. The Recognise Online component is immediately emailed to the address your supply when purchasing the pack which means you can start on laterality exercises straight away. The Flash Cards and Mirror Box are shipped after your purchase and delivery time will depend on your location and the freight option chosen.
Q. If the patient has good results when you test their laterality eg: 90% accuracy in 3-4 seconds on both sides do you skip the laterality and go straight onto imagined movement?
A. Yes, but always check laterality if there is ever a relapse.
Q. If the imagined movement in the hand is stirring up pain could you start with imagined movement in the foot or in the shoulder and gradually move closer as some movement is tolerated?
A. Yes. It is important to understand that the GMI programme has broad stipulations but also needs to be designed to the specific needs of each patient. If this means starting with graded exercises from the foot/shoulder/arm and working towards the hand until the patient can tolerate those exercises then that is what needs to be done.
Q. Do you move onto imagined movement once the laterality improves or are there other indicators for when you should progress?
A. We can only make broad suggestions here. It is best to try and keep to the research findings, where possible, of the progression of laterality, imagined input (motor imagery), and mirrors. However, some ‘mixing’can be used. Note that it is worth keeping a check on laterality as it could be lost when the patient is stressed.
Q. Do you use the flash cards with the mirror or alone?
A. Flash cards are a separate tool and are great for laterality and motor imagery exercises. If you have not yet mastered your laterality, mirror therapy should not be attempted. If you have mastered your laterality and are working on imagined movements, it is possible to start integrating some mirror therapy throughout your day along with the imagined movements.
Q. Would you expect the perception of the limb to change with the GMI programme or does that come later.
A. It could change at any time during the process of GMI.
Q. With the mirror work is it best to get the patient to attempt some movement of the affected limb at the same time?
A. Nobody really knows. This is a clinical decision. Broadly – if the affected body part is sensitive, forget about the limb in the box and work the limb outside. If less sensitive reciprocal movements can be used. Watch the noigroup mirror therapy video.
Q. Is it best used in the acute stage or are patients in the chronic stage just as likely to benefit? In fact do they need it more?
A. This is something you need to test and see. Some patients have not lost laterality and this could depend on many factors - in fact some patients with chronic pain may have laterality intact.
Q. If the patient hates the limb where do you start?
A. Somehow the patients have to ‘take the limb back’ and get to like it again. Try to grade the exposure to the limb. These patients may need to seek further medical advice.
Q. In using the GMI programme one of my patients has improved his proprioception and he is taking much more care of the limb – is this what you would expect?
A. This depends on what you mean by ‘care’. If ‘care’ is greater protection and focusing on the limb this may not be useful. If ‘care’ is trying to reintegrate the limb into functional activities this would be beneficial.

Related NOI Products

Graded Motor Imagery Pack	Recognise™ Online	Flashcards (hands + feet)	Mirror Box