What is it?

  • Rehabilitation program used to treat pain, aid recovery from injury and improve performance
  • Exercise the brain
  • Increase difficulty as progress is made

Hand Laterality Recognition

  • Attempt to correctly identify whether images of hands are left or right
  • The images may be in magazines, on television, or belong to your family or friends
  • You can use the Recognise Cards or Recognise online – available from your therapist or download the app
  • Aiming for 80% success rate, under 2 seconds per image
  • This technique can reduce pain and swelling in your hand
  • Recognise Cards – sort into left or right piles, find matching pairs
  • Repeat every second hour

Imagined Movements

  • Use either the recognise app or the recognise cards or look through a magazine or paper to find images of hands
  • Imagine moving your arm into the posture of the hand of the image
  • By imagining movements, you use similar areas of the brain that are used when you actually move
  • Talk to your therapist how to grade the task


Imagine your hand moving







Mirror Box Therapy

Use a mirror to trick the brain into believing that an injured part is actually ok. Hide the affected hand behind the mirror so you cannot see it. Put you unaffected hand opposite the mirror. Look into the reflection of the mirror whilst completing movements.


  • Start by just looking at the reflection of the hand
  • Do exercises with the unaffected hand only
  • Do exercises with both hands
  • Start with exercises that are not normally painful and progress to more provocative movements
  • Do activities/use tools with your hands

Change the context to ensure generalisation

  • Change location (kitchen, garden, office)
  • Emotions (do when happy or sad)
  • Time of day
  • Different postures (sitting/lying/standing)
  • Be distracted (smells/noises/balance of one leg)
  • Use all senses (touch/feel/smell/hear/see)
  • Use metaphors (eg open hand to ‘free the bird’


Look at your hand in the mirror





Do exercises whilst looking at the reflection in the mirror









Cortical Reorganisation

  • Trace a line around your arm and hand
  • Divide the drawing into sections and label with numbers
  • Ask another person to touch your hand and arm with either of a cork or the end of a straightened paper clip
  • Without looking, attempt to identify where they are touching you and what they are touching you with
  • Repeat at least twice a day, with 20 touches each time


Trace around your hand and divide/label sections






Click below to access PDF version

Graded Motor Imagery