Added effect of graded motor imagery to rehabilitation protocol for post-operative rotator cuff repair on pain, kinesiophobia, functions, and mobility—a randomized controlled pilot study

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.