MOTOR IMAGERY. for the Treatment of. Patient Information Booklet

Transcription

1 MOTOR IMAGERY This booklet was produced by Marielle Blain, nurse clinician and Dr. François Gobeil, anesthesiologist Pain Management Consultation Unit, CSSS Pierre Boucher In collaboration with DSIPP CSSS Pierre Boucher and CSSS Rouyn randa for the Treatment of Publication funded by an unrestricted education grant from Pfizer Canada Inc. Patient Information Booklet

2 You have been diagnosed with a condition known as Complex Regional Pain Syndrome (CRPS) after undergoing medical tests, examinations and evaluations. The cause of CRPS is unknown, but this rare disorder can seriously impact your quality of life. In medical terms, CRPS is defined as WEEK 11 a ful condition following a relatively minor injury to a limb. It is more severe and lasts much longer than would normally be expected given the injury. The symptoms of Complex Regional Pain Syndrome (CRPS) are sometimes hard to describe. They vary from person to person and often change over time. Here are some of the s experienced in the affected limb: Spontaneous caused by touch, movement, brushing, friction, and heat or cold Unusual burning s like electric shocks, numbness, pins-andneedles, and tingling Changes in skin colour and temperature Increased or decreased sweating Nail changes (nails become harder, more breakable, grow faster or slower) Coordination problems, tremor, and difficulty performing certain movements It may be hard for you to understand your condition, especially when the persists longer than it should. This can lead to anxiety or depression. Recent research on the mechanisms involved in CRPS has led to the development of a new therapy, which may bring you some relief. When you have CRPS, there is a change in how your brain takes in and processes information from the affected limb. The brain becomes disorganized in how it receives, recognizes and handles signals and information coming from the affected limb, almost like an optical illusion. When you have CRPS, the specific place on the surface of the brain, represented by the affected limb, shrinks. : : : 2 : : : : : : 19 : : :

3 WEEK 10 The brain tries to protect itself by rejecting the affected limb. At the same time, another part of the brain, which is used to receiving constant information from the affected limb, tries to retrieve this data by turning up the volume like when you turn up the volume on the radio to hear it better. This produces an increase in background noise and extreme sensitivity as well as all of the other symptoms you may be experiencing. Australian researchers have used this new concept to develop an approach designed to reprogram the brain so that it can correctly receive, recognize and process the signals being sent by the affected limb. You are being invited to try motor imagery therapy for the next 8 to 12 weeks. Motor imagery therapy This therapy is divided into 4 phases, each of which lasts about 2 to 3 weeks. The therapy involves doing exercises at home. During each of the 4 phases, you will be asked to do the exercises 3 times a day, 6 days a week. Each session lasts 10 minutes. You must do the exercises in the prescribed order and you must follow the clinic professionals recommendations. At the first meeting, you will be given instructions and all the necessary equipment so that you can start your treatment at home. Clinic professionals will call you regularly after this first visit, and will make appointments to see you between each phase. Once you have completed all 4 phases of the therapy, you will undergo a final evaluation. : : : 18 : : : : : : 3 : : :

4 Remember. Your goal is just to complete each phase of the treatment. There is no competition involved - no winners and no losers. WEEK 9 Time your s for when you feel best. Your treatment will be more successful if you do the exercises in a quiet, relaxed environment. Do the exercises to the best of your abilities, but without causing. If you feel more or a change in any of the other symptoms in your affected limb, stop the. If this happens, write down how many minutes you completed in the before stopping. You should then stop the next one minute earlier, or omit the image that caused the problem. Please notify clinic staff of any problems. Try to use your affected limb regularly when you go about your day to day activities. These movements should not cause. Simply initiating a movement with the affected limb is already a sign of improvement. Stimulate your affected limb with different pleasant textures, materials and objects like soft fabrics, brushes, sand, rice, water It is important to avoid changing your medications during the treatment process. Please don t hesitate to contact the clinic professionals if you have any problems, if there is any change in your or other symptoms, or if you plan to start other therapies or exercises. Please fill out the log at the end of this booklet after the last of the day. This log plays a very important role in your treatment. Please write down any changes that occur in your condition, for instance, changes in the amount of you experience in your affected limb before or after each, or changes in any of your other symptoms. Get ready to play an active role in treating and curing your condition. Your involvement is vital throughout the treatment process. : : : 4 : : : : : : 17 : : :

5 WEEK 8 Identifying right and left limb Phase 1 mirror Look carefully at the images of the feet or hands. Decide spontaneously if the picture shows a right or left limb. Do this: 10 minutes, 3 times a day 6 days a week Use the CD, DVD, cards or video Look at the pictures carefully. Answer spontaneously: right or left. Try to count the number of errors you make during each. Someone can help you for that. Do not use the mirror during this phase. Try not to move your hands or feet. : : : 16 : : : : : : 5 : : :

6 During phases 2, 3 and 4, you must use a mirror for this technique. When you use the mirror, place your affected limb in the mirror box or hide it behind a large mirror (depending on your specific case). Watch the reflection of your healthy limb in the mirror. WEEK 7 Phase 2 Using a mirror Imagine the movement shown: 10 minutes, 3 times a day 6 days a week Use the CD, DVD, cards or video. Use the mirror as instructed. Look at the pictures carefully. Watch the reflection of your healthy limb in the mirror. Imagine performing the movement shown on the screen, and then imagine your limb at rest. Repeat 3 times for each image. If some of the images cause you, imagine performing the movement shown on the screen while looking at your healthy limb, not its reflection in the mirror. Your healthy limb and the affected limb should remain immobile. Do not move them at all during this phase. : : : 6 : : : : : : 15 : : :

7 WEEK 6 Perform the movement shown moving only your healthy limb Phase 3 Using a mirror 10 minutes, 3 times a day 6 days a week Use the CD, DVD, cards or video. Use the mirror as instructed. Look at the pictures carefully. Perform the movement shown slowly and carefully, using only your healthy limb, while watching its reflection in the mirror. Repeat 5 to 10 times. Relax the healthy limb between each movement. Do not move the affected limb in the mirror box or behind the large mirror. Phase 4 Using a mirror This time, perform the movement illustrated using both limbs 10 minutes, 3 times a day 6 days a week Use the CD, DVD, cards or video. Use the mirror as instructed. Look at the pictures carefully. Perform the movement shown slowly and carefully, moving your healthy limb and affected limb at the same time, while watching the reflection of the healthy limb in the mirror. Repeat 5 to 10 times. Relax the healthy limb and affected limb between each movement. It is very important to synchronize the movements of the healthy limb and the affected limb (move them both at the same time). : : : 14 : : : : : : 7 : : :

8 You have now completed your treatment. Hopefully, you have made significant progress over the past several weeks. WEEK 5 The goal of motor imagery is to free you from CRPS and to help you recover from your injury. At your final visit, the team s medical professionals will propose an appropriate complimentary therapy (physiotherapy, occupational therapy, etc.) to help you increase your functional capacity. You are encouraged to resume your activities and exercise programs gradually. We encourage you to share your suggestions or comments with us so that we can improve our approach to treating Complex Regional Pain Syndrome. Good luck! :: : : 8 :: : : : : : 13 : : :

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