Effect of Motor Imagery Training on Pain, Functionality, Proprioception and Kinesiophobia in Partial Rotator Cuff Tear

Kutahya Health Sciences University

Status: Enrolling

Conditions: Rotator Cuff Tears

Treatments: Other: Motor Imagery Training; Other: Traditional Physiotherapy

Study type: Interventional

Funder types: Other

Identifiers

NCT06875895

KSBU-RC

Details and patient eligibility

About

The aim of this study is to investigate the effects of motor imagery training on pain, functionality, proprioception and kinesiophobia in patients with partial rotator cuff tears. Participants will be randomly assigned to traditional physiotherapy and motor imagery groups. Interventions will be performed with a physiotherapist for a total of 20 sessions for 4 weeks, 5 days a week. The intervention program will be determined by the Specialist Physical Therapy Physician. Data will be collected before the study, at the end of the training in the 4th week and at the 8th week (follow-up evaluation). Motor imagery ability will be assessed with the Movement Imagery Questionnaire (MIQ-R), pain will be assessed with the Numerical Assessment Scale for functionality with the DASH, proprioception will be assessed with the inclinometer and kinesiophobia will be assessed with the Tampa Kinesiophobia Scale.

Full description

One of the most common pathologies related to the shoulder joint, which has a wide range of motion, is the tears of varying degrees in the rotator cuff muscles. The rotator cuff muscles consist of the dynamic stabilizers of the shoulder: supraspinatus, infraspinatus, subscapularis and teres minor muscles. Pathologies related to the rotator cuff can present as simple overuse, impingement syndrome, partial tear, full-thickness tear and, in the advanced stage of the tear, rotator cuff tear arthropathy. Such tears can usually occur due to injuries and traumas, degeneration due to aging, overuse or repetitive movements. The main symptoms of a partial rotator cuff tear are increased shoulder pain during overhead movements, limited movement, muscle weakness and loss of function. Partial rotator cuff tear is usually diagnosed with physical examination and imaging techniques such as MRI (Magnetic Resonance Imaging), ultrasonography, and X-ray. The treatment approach varies depending on the size of the tear, the patient's symptoms, and lifestyle, and is divided into conservative treatments and surgical techniques. Motor imagery is the individual's conscious simulation of the movement without any motor output. Motor imagery contributes to the improvement of motor performance and the learning of new motor skills. Motor imagery is divided into two as visual and kinesthetic imagery. While visual imagery consists of visualizing the movement, kinesthetic imagery focuses on the position of the muscles and limbs and the somatic sensations created by their movement. Studies combining motor imagery with classical physiotherapy training show that it increases the effectiveness of the treatment.

Enrollment: 80 estimated patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Partial rotator cuff tear diagnosis.
• Between the ages of 18-65
• Patients experiencing pain for at least 4 weeks.
• Having a valid score on the Mini Mental Test (>24)
• Those without a history of any neurological or serious psychological illness.
• Those who have not participated in a previous study on motor imagery training

Exclusion criteria

• Complete rotator cuff tear or conditions requiring surgical intervention,
• Participants who have received treatment with corticosteroids by any means in the previous 6 months,
• Participants who have a rotator cuff tear due to acute traumatic conditions (proximal humerus fracture).

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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80 participants in 2 patient groups

Control Group (Traditional Physiotherapy)

Active Comparator group

Description:

Traditional physical therapy will begin with the application of Hotpack, Tens and Ultrasound to the painful area for five minutes. Then, stretching exercises will be performed at the pain limit for the six main shoulder movements in the shoulder joint. Then, wand exercises, pendulum exercises, isometric exercises for the shoulder joint and strengthening active exercises will be given in order to increase the normal range of motion in the shoulder joint. The six main shoulder movements will be actively performed (flexion, extension, abduction, adduction, medial and lateral rotations). After the 5th session, weights will be added according to the patient's condition.

Treatment:

Other: Traditional Physiotherapy

Motor Imagery Training

Experimental group

Description:

In motor imagery training, exercises in traditional physiotherapy will be applied with kinesthetic and visual motor imagery. Each movement will be divided into five sets consisting of two trials separated by 10 repetitions and 30-second rest periods. It will also be emphasized through practice that the functional movement imagined and the times when this movement is actually actively performed should be similar. Individuals' eyes will be closed throughout the entire motor imagery training. At the very beginning of the session, a relaxation exercise lasting approximately 5 minutes will be performed in order to maximize attention during motor imagery. Whether or not individuals are performing imagery will be monitored by monitoring heart rate variables from autonomic functions. In order to ensure standardization during imagery, commands will be applied with audio recordings containing metaphors.

Treatment:

Other: Motor Imagery Training