Effectiveness of movement representation techniques in non-specific shoulder pain: a systematic review and meta-analysis

Abstract This systematic review and meta-analysis aims to assess the effects of movement representation techniques (MRT) on pain, range of motion, functional outcomes, and pain-related fear in patients with non-specific shoulder pain (NSSP). A literature search conducted in PubMed, PEDro, EBSCO, Sco...

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Main Authors: Nuray Alaca, Ali Ömer Acar, Sergen Öztürk
Format: Article
Language:English
Published: Nature Portfolio 2025-01-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-024-84016-9
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author Nuray Alaca
Ali Ömer Acar
Sergen Öztürk
author_facet Nuray Alaca
Ali Ömer Acar
Sergen Öztürk
author_sort Nuray Alaca
collection DOAJ
description Abstract This systematic review and meta-analysis aims to assess the effects of movement representation techniques (MRT) on pain, range of motion, functional outcomes, and pain-related fear in patients with non-specific shoulder pain (NSSP). A literature search conducted in PubMed, PEDro, EBSCO, Scopus, Cochrane Library, ScienceDirect, and gray literature on April 31, 2023. We selected seven randomized controlled trials based on the PICOS framework. Incomplete data or non-NSSP excluded. Study quality was assessed using the PEDro scale (mean score = 6.43), and certainty of evidence was evaluated with the GRADE approach. MRT demonstrated a large effect size for pain reduction (high heterogeneity, I2 = 85.2%, Hedges’g = 1.324, 95% CI = 0.388–2.260, P = 0.006), functional improvement (moderate heterogeneity, I2 = 70.82%, Hedges’g = 1.263, 95% CI = 0.622–1.904, P < 0.001), and reduction of pain-related fear (moderate heterogeneity, I2 = 70.86%, Hedges’g = 0.968, 95% CI = 0.221–1.716, P < 0.001). MRT also showed significant benefits for range of motion, particularly in flexion (low heterogeneity, I2 = 26.38%, Hedges’g = 0.683), abduction (low heterogeneity, I2 = 33.27%, Hedges’g = 0.756), and external rotation (low heterogeneity, I2 = 48.33%, Hedges’g = 0.542) (P < 0.001 for all), while no significant effect was found for internal rotation (P > 0.05). No publication bias was detected. While limited evidence and methodological concerns necessitate further research, MRT appears to positively impact pain, range of motion, functional outcomes, and pain-related fear in NSSP patients.
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spelling doaj-art-d8f4756964a5432ea61685658d5b05f02025-08-20T01:47:58ZengNature PortfolioScientific Reports2045-23222025-01-0115111410.1038/s41598-024-84016-9Effectiveness of movement representation techniques in non-specific shoulder pain: a systematic review and meta-analysisNuray Alaca0Ali Ömer Acar1Sergen Öztürk2Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, University of Acibadem Mehmet Ali AydınlarFaculty of Health Sciences, Department of Physiotherapy and Rehabilitation, University of Acibadem Mehmet Ali AydınlarFaculty of Health Sciences, Department of Physiotherapy and Rehabilitation, University of Acibadem Mehmet Ali AydınlarAbstract This systematic review and meta-analysis aims to assess the effects of movement representation techniques (MRT) on pain, range of motion, functional outcomes, and pain-related fear in patients with non-specific shoulder pain (NSSP). A literature search conducted in PubMed, PEDro, EBSCO, Scopus, Cochrane Library, ScienceDirect, and gray literature on April 31, 2023. We selected seven randomized controlled trials based on the PICOS framework. Incomplete data or non-NSSP excluded. Study quality was assessed using the PEDro scale (mean score = 6.43), and certainty of evidence was evaluated with the GRADE approach. MRT demonstrated a large effect size for pain reduction (high heterogeneity, I2 = 85.2%, Hedges’g = 1.324, 95% CI = 0.388–2.260, P = 0.006), functional improvement (moderate heterogeneity, I2 = 70.82%, Hedges’g = 1.263, 95% CI = 0.622–1.904, P < 0.001), and reduction of pain-related fear (moderate heterogeneity, I2 = 70.86%, Hedges’g = 0.968, 95% CI = 0.221–1.716, P < 0.001). MRT also showed significant benefits for range of motion, particularly in flexion (low heterogeneity, I2 = 26.38%, Hedges’g = 0.683), abduction (low heterogeneity, I2 = 33.27%, Hedges’g = 0.756), and external rotation (low heterogeneity, I2 = 48.33%, Hedges’g = 0.542) (P < 0.001 for all), while no significant effect was found for internal rotation (P > 0.05). No publication bias was detected. While limited evidence and methodological concerns necessitate further research, MRT appears to positively impact pain, range of motion, functional outcomes, and pain-related fear in NSSP patients.https://doi.org/10.1038/s41598-024-84016-9Motor imageryAction observationMirror therapyVisual mirror feedback therapyGraded motor imageryPain
spellingShingle Nuray Alaca
Ali Ömer Acar
Sergen Öztürk
Effectiveness of movement representation techniques in non-specific shoulder pain: a systematic review and meta-analysis
Scientific Reports
Motor imagery
Action observation
Mirror therapy
Visual mirror feedback therapy
Graded motor imagery
Pain
title Effectiveness of movement representation techniques in non-specific shoulder pain: a systematic review and meta-analysis
title_full Effectiveness of movement representation techniques in non-specific shoulder pain: a systematic review and meta-analysis
title_fullStr Effectiveness of movement representation techniques in non-specific shoulder pain: a systematic review and meta-analysis
title_full_unstemmed Effectiveness of movement representation techniques in non-specific shoulder pain: a systematic review and meta-analysis
title_short Effectiveness of movement representation techniques in non-specific shoulder pain: a systematic review and meta-analysis
title_sort effectiveness of movement representation techniques in non specific shoulder pain a systematic review and meta analysis
topic Motor imagery
Action observation
Mirror therapy
Visual mirror feedback therapy
Graded motor imagery
Pain
url https://doi.org/10.1038/s41598-024-84016-9
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AT sergenozturk effectivenessofmovementrepresentationtechniquesinnonspecificshoulderpainasystematicreviewandmetaanalysis