Graded Motor Imagery
Research shows people in pain often lose the ability to identify left or right images of their painful body part(s) (i.e. when viewing pictures of body parts they are slower and/or less accurate than somebody without pain at determining whether the image is a Left or Right).
This ability appears to be important for normal recovery from pain. The good news is that the brain is plastic and changeable, if given the right training for long enough. So with the appropriate tools, a bit of work, patience and persistence, it is possible to improve the ability (speed and accuracy) to discriminate between Left and Right body parts and movements.
- Is it a left or right? When doing these exercises with hands, feet, knees and shoulders your aim will be to determine whether the body part is from the left or the right side. For example, is it a left shoulder or a right shoulder?
- Has it moved to the left or right? For all spinal and facial exercises (backs, necks, faces) you want to answer whether the body part has twisted, turned or moved to the left or right. For example, is he leaning to the left or right?
- Some useful tools for training in left/right discrimination are the online Recognise software, Recognise Apps, Recognise Flash Cards and other readily available tools such as magazines (with people pictures), Google images, Facebook photos, photo albums.
- See 'what is normal' for our current ideas on the level of results you should aim for.
So… what is normal?
Left/right judgement tasks are required to fall within a certain range of speed (average response time in seconds) and accuracy (percentage of correct answers) to be considered as normal. Compare the 'normal' figures below with your own Recognise results. Note the changes in your Recognise results as you practise and progress through the different levels of difficulty.
Our broad suggestions for normal responses to a left/right discrimination test are:
- Accuracy of 80% and above
- A speed of 1.6 seconds +/- 0.5 sec appears quite normal for necks and backs. Hands and feet are a little slower with an average speed of 2 seconds +/- 0.5 sec. Based on these figures we would suggest that around 2 seconds is quite normal for other body parts such as knees and shoulders.
- Accuracies and response times should be reasonably equal for the left and right
- Results should be stable (eg they don't fade out with stress) and are consistent for at least a week.
- A judgement will also be needed on the personal relevancy of the responses. For example, minor left/right discrimination changes may not be so relevant in a person who has a severe pain related incapacity whereas they may be more relevant in a person with a much more minor problem. This is a clinical reasoning judgement.
NOTE: these 'normal' results are based on studies of hundreds of people and act as a guide only. There may be reasons why, after months of practise, you still find it impossible to get results within these normal ranges. Aim for the normal range and give it a real go but don't be upset if you can't get there!
For more information see The Graded Motor Imagery Handbook, Moseley, Butler, Beames, Giles, Noigroup Publications, 2012
Recognise online - Online programme for left/right discrimination, recognition and restoration
Recognise Flash Cards - 48 left and right images. Available with hands, feet, shoulders, backs and necks. Card games, reference list and instructions included.
Magazines, photo albums, digital cameras