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Updated: Jun 18, 2026

Structured Motor Rehabilitation After Selective Nerve Transfers
Published on: August 15, 2019
Added effect of graded motor imagery to rehabilitation protocol for post-operative rotator cuff repair on pain,
Vandana Chandaragi1, Peeyoosha Gurudut1, Sahil Kale2
1Department of Orthopedic Physiotherapy, KAHER Institute of Physiotherapy, KLE Academy of Higher Education and Research, Belagavi, India.
Background:
Severe grade rotator cuff injuries require surgery, but post-surgical pain and kinesiophobia can hinder rehabilitation. Graded Motor Imagery (GMI) aids to reduce these challenges through its three phases. However, there is less supporting evidence on the effect of GMI in post-surgical shoulder rehabilitation cases.
Objective:
To explore the added effect of GMI combined with conventional rehabilitation on pain, kinesiophobia, functions, and joint mobility following rotator cuff repair.
Methods:
16 participants (aged 45-60) were randomly assigned to experimental (GMI + conventional rehabilitation) and control (conventional rehabilitation) groups. Primary outcome was pain (NPRS), and secondary outcomes were kinesiophobia (TSK), shoulder function (Quick DASH), and mobility (goniometer). Assessments occurred pre-operatively, 3rd post-op day pre-rehab, and post---rehab after 3 weeks. Phase 1 GMI began post-immobilization (day 3) in the hospital; Phases 2 and 3 followed on alternate days after discharge via home or OPD sessions according to the convenience of the patient.
Results:
At 3 weeks, experimental group showed improvements across all measures, pain (d = -2.55; P = .002), kinesiophobia (d = -3.18; P = .001), functional status (d = -1.71; P = .007) and shoulder mobility flexion (d = 4.65; P = .0001), abduction (d = 6.43; P = .0001), Internal (d = 1.48; P = .012) and External rotation (d = 2.71; P = .002).
Conclusion:
Adding GMI to conventional post-surgical rehabilitation may help to reduce pain and kinesiophobia, thereby improving functional outcomes and mobility following rotator cuff repair.
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