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

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.

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.

Eligibility Criteria:
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).