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Table 2 Summary of progressions used for the Graded Motor Imagery (GMI) training program

From: A central nervous system-focused treatment approach for people with frozen shoulder: protocol for a randomized clinical trial

Stage

GMI training

1 (weeks 0–2)

Laterality recognition

Using Recognise software

Determine whether left or right side of shoulder

Progress by time for which image was presented

2 (weeks 2–4)

Imagined movements

Using video of model performing movements

Small-range movements during first week

Full-range movements during second week

3 (weeks 4–6)

Isometric local muscle recruitment

Rotator cuff muscles

Scapular muscles

Add pain-free movement to local contraction

4 (weeks 6–8)

Mirror therapy

Keep the affected arm still in a comfortable position/keep the unaffected arm still in the same position and just observe the reflection

Keep the affected arm still in a comfortable position/move the unaffected arm through its full-range of movement (ROM) in different directions

5 (weeks 8–10)

Mirror therapy

Move the affected arm towards the limit of pain in the restricted/painful direction(s) of movement and keep that position/move the unaffected arm through its full ROM in the painful/limited directions

Move the affected arm towards the limit of pain in the restricted/painful direction(s) of movement/copy with the unaffected arm through a full ROM (synchronous movements)