Effects of a Motor Imagery Exercise Protocol in Patients With Fibromyalgia

University of Roma La Sapienza

Status: Completed

Conditions: Fibromyalgia; Pain, Chronic; Image, Body; Psychological Distress

Treatments: Other: Conventional physical therapy; Other: Motor Imagery physical therapy

Study type: Interventional

Funder types: Other

Identifiers

NCT03870932

URomLS-2018

Details and patient eligibility

About

The aim of this study was to evaluate the efficacy of a novel approach with a motor imagery-based exercise program versus conventional rehabilitative approach in fibromyalgia syndrome (FM): reduction of pain was set as the primary outcome.

Full description

Evidence about the therapeutic efficacy of exercise intervention programs in FM is still low and many authors suggested improving standardized exercise prescription for FM to achieve optimal results. In the literature, as an alternative approach, rehabilitative protocols in Group Music and Imagery seem to improve well-being and reduce anxiety in women with FM and suggest that Music and Imagery may help diminish pain intensity and depression. A rehabilitative approach should also consider the psychological and emotional aspects and, when possible, be accompanied by cognitive-behavioral therapy. The purpose of this research is to evaluate the possible efficacy of a novel approach with a motor imagery-based exercise program versus conventional rehabilitative approach in FM syndrome: the reduction of pain was set as the primary outcome as well as taking into account the patient's psychological and emotional condition. This study was designed as a double-blind, randomized, controlled trial.

Enrollment: 29 patients

Sex: Female

Ages: 18 to 60 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• experienced widespread pain for more than 3 months
• pain with 4 kg/cm2 pressure at 11 or more of the 18 tender points
• aged 18 to 60 years
• pharmacological therapeutic regimen must have been stable for at least three months before

Exclusion criteria

• pregnant women
• pacemaker wearers
• overlapping painful conditions
• presence of autoimmune or hematologic diseases
• psychiatric disorders in pharmacological and psychological treatment
• other causes of chronic pain
• other diseases such as epilepsy, tumors, major neurological problems and diabetes

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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29 participants in 2 patient groups

Motor imagery rehabilitative group (MIG)

Experimental group

Description:

All patients performed 10 treatment sessions, lasting 60 to 90 minutes, twice a week, in groups of three to four patients. The gold standard was to choose simple and safe exercises in order to encourage the patient to repeat the schedule at home. The exercises proposed in the MIG have been chosen respecting the following principles: slowness, painlessness, promoting attention, easy to imagine. The main purpose of motor imagery-based exercises was to bring the patient back to "feeling and self-perceiving" the execution of the movement. More than the "quantity" of repetition, the "quality" of the movement, free from pain, was important.

Treatment:

Other: Motor Imagery physical therapy

Control rehabilitative Group (CG)

Active Comparator group

Description:

The CG received a conventional rehabilitation protocol, based on ten 1-hour sessions, held twice a week (over a 5-week period), previously investigated as efficient in FM by the authors and published. The exercises included low-to-moderate impact aerobic training, walking in a circle, alternating with periods of going up and down the stairs (3 steps for 10 minutes), for a total of 20 consecutive minutes, posture exercises for the back and proprioceptive exercises for the trunk, to improve axial stability. Each exercise was repeated 10 times (3 sets of 10), with a resting period of at least 3 minutes between sets. All sessions ended with stretching and diaphragmatic breathing exercises.

Treatment:

Other: Conventional physical therapy