Pain Neuroscience Education and Motor Imagery-based Exercise Protocol for Patients With Fibromyalgia
Condition: Fibromyalgia; Pain; Psychology Regression
MeSH terms: Fibromyalgia; Myofascial Pain Syndromes
Study type: Interventional

Summary: 
      The main aim of this study is to find out whether applying both pain neuroscience education
      (PNE) and motor imagery-based exercise protocol (MIEP) will primarily reduce the pain of
      fibromyalgia. These therapies could show an evidence of improvement in fibromyalgia patients.
      However, there are no studies evaluating their effectiveness in combination.

      Secondary outcomes:

      To assess motor imagery ability of PNE in fibromyalgia patients

      To assess motor imagery ability of MIEP in fibromyalgia patients

      To evaluate the motor imagery ability of PNE+MIEP combined in fibromyalgia patients

      To evaluate pain beliefs of PNE in fibromyalgia patients

      To assess the pain beliefs of MIEP in fibromyalgia patients

      Combined PNE+MIEP to assess pain beliefs in fibromyalgia patients.

      To assess fear of movement in fibromyalgia patients of PNE

      To assess fear of movement in fibromyalgia patients of MIEP

      Combined PNE+MIEP to assess fear of movement in patients with fibromyalgia

      PNE to assess anxiety, depression, cognitive and mood in patients with fibromyalgia.

      To assess anxiety, depression, cognitive and mood in patients with fibromyalgia MIEP

      To evaluate anxiety, depression, cognitive and mood in patients with fibromyalgia together
      with PNE+MIEP

      PNE to assess self-esteem and body awareness in fibromyalgia patients.

      To assess self-esteem and body awareness in fibromyalgia patients of MIEP

      Combined PNE+MIEP to assess self-esteem and body awareness in fibromyalgia patients.
    


Intervention name(s): Pain neuroscience education (PNE); Motor imagery-based exercise protocol (MIEP); Combination Group
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): Pain neuroscience education (PNE) is a health education intervention that aims to provide up-to-date information on neuroscience developments in the field of chronic pain. All patients were trained once a week for 12 weeks, in groups of 3-4 people, for a maximum of 6 sessions and a minimum of 60 minutes. During the intervention, psychological factors such as self-efficacy, pain intervention/injury, coping with pain, catastrophic thoughts, emotional response to pain, anxiety, frustration/anger, fear of harm, concerns about pain, and fear of pain were examined. and discussed with patients. The sessions aimed to provide patients with a better understanding of their chronic pain by addressing the multifactorial aspects of chronic pain, sensitization and the plasticity of the brain, thus involving patients in treatment.; All patients performed sessions of maximum 60 minutes in groups of 3-4 people twice a week for 12 weeks. This study protocol was developed in accordance with the Consolidated Standards of Reporting Trials (CONSORT) guidelines. The key standard was to practice simple and safe exercises that would encourage the patient to repeat the program at home. The exercises proposed in MIEP were selected according to the following principles: slowness, painlessness, arousing attention, easy to imagine. The main purpose of the motor imagery exercises was to bring the patient back to the state of "feeling and self-perception" of the execution of the movement. More important than the "quantity" of repetition was the painless "quality" of movement. It was performed in 3 phases: relaxation (3 minutes), MI (8.5 minutes per image) and refocus (3 minutes), which included both kinesthetic imagery (KI) and visual imagery (VI).; Subjects received 6 sessions of Pain neuroscience education (PNE) and 12 weeks (2 times a week) of Motor imagery-based exercise protocol (MIEP).
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary purpose: Treatment