Effectiveness of motor imagery in complex regional pain syndrome: A systematic review with meta-analysis.

OBJECTIVE: The purpose of this study was to determine the effects of motor imagery (MI) on pain intensity and disability in individuals with complex regional pain syndrome (CRPS). METHODS: A systematic search was conducted in various electronic databases to identify all relevant studies: PubMed, CINAHL, WOS, PEDro, CENTRAL, and Scopus. Randomized controlled trials assessing the effects of MI in individuals with CRPS were included. The risk of bias was assessed with the Cochrane Risk of Bias tool, the methodological quality was evaluated using PEDro scale, and the level of evidence was reported according to the GRADE. Between-groups standardized mean differences (SMD) were calculated. RESULTS: Six studies were included. The meta-analysis found moderate-quality evidence that MI improves pain intensity and related disability as immediate (pain: SMD -1.07, 95% CI: -1.53 to -0.60; disability: SMD 1.05, 95% CI: 0.59 to 1.51), short-term (pain: SMD -1.28, 95% CI: -2.14 to -0.42; disability: SMD 1.37; 95% CI: 0.16 to 2.58), and long-term effects (pain: SMD -1.18; 95% CI: -1.89 to -0.46; disability: SMD 1.18; 95% CI: 0.46 to 1.89), as compared with a comparison group. The risk of bias of the trials was relatively low, but the imprecision of the results downgraded the level of evidence. CONCLUSIONS: Moderate-quality evidence suggests a positive effect of MI for improving pain intensity and disability immediately after and at short-term in individuals with CRPS.

Prevalence and Factors Associated With Injuries in Elite Spanish Volleyball.

CONTEXT: Prevalence studies have been carried out widely on elite volleyball players. However, the extent to which specific prevention strategies are used and the influence of the sport equipment on the occurrence of injuries have been sparsely investigated. OBJECTIVE: To describe the prevalence of injuries sustained during 1 season in elite Spanish volleyball leagues and to investigate the association of injuries with factors such as player court position, injury mechanism, type of shoes used when playing, or participation in prevention activities. DESIGN: Descriptive cross-sectional epidemiology study: observational study. SETTING: European elite professional volleyball. PARTICIPANTS: Professional volleyball players from the elite Spanish volleyball league. MAIN OUTCOME MEASURES: A self-report questionnaire assessed the presence of injury during a volleyball season. Questions included the type of injury, its anatomic location, participation in prevention strategies, shoe type, the injury mechanism, the season period, the period of leave, and the treatment received. RESULTS: In total, 490 players (71.2% response rate) completed and returned the questionnaire. The injury prevalence was 66.9%, and the average of injuries per player was 0.94 (0.85) (range: 0-4). Most Spanish elite volleyball players participated in prevention programs during the season (90.3%) and played volleyball with low-top shoes (83.6%), but these factors were not associated with the prevalence of injuries (P > .05). The anatomic regions with the most injuries were the ankle, knee, and shoulder; the most common types of injury were sprains, tendinopathies, and strains, usually occurring during blocking and attack actions during the in-season period. CONCLUSIONS: Despite most elite volleyball players participating in prevention programs, the results reveal a high injury prevalence. Further prospective research on the effectiveness of prevention strategies in elite volleyball is needed.