Impact of Motor Imagery in the Functional Rehabilitation of Patients With Chronic Low Back Pain: a Randomised Controlled Trial

Summary

Non-specific low back pain (NSLBP) is a very common condition and one of the leading causes of disability worldwide. It has a significant impact on quality of life, with functional, locomotor and psychological repercussions, and is often associated with kinesiophobia (excessive fear of movement due to apprehension related to pain or injury). For the most severe cases, multidisciplinary rehabilitation programmes are recommended. The objectives are, on the one hand, to offer reconditioning to exercise and, on the other hand, to educate, raise awareness about physical activity and help combat fears in order to reduce symptoms, improve quality of life and re-engage in daily and professional activities. However, these programmes are not entirely effective, and many of you still live with chronic lower back pain.

To improve the management of lower back pain, it is important to understand how the body functions with this condition, particularly when there is chronic pain. It has been shown that people suffering from lower back pain often have difficulty controlling their movements. This means that their brain is less able to prepare certain movements. One method that can help improve movement preparation and control is motor imagery (MI). This involves imagining a movement without physically performing it. This technique activates the same areas of the brain as when the movement is performed. This is why it can be beneficial and help improve treatment.

This research will evaluate the effectiveness of an innovative rehabilitation programme incorporating motor imagery (MI) in patients with chronic low back pain. MI could improve motor skills at the end of rehabilitation as well as quality of life. Conversely, the inability to perform certain movements, kinesiophobia and pain could be reduced.

Each participant will follow the REAGIR multimodal rehabilitation programme at the Dijon Bourgogne University Hospital (7 hours of rehabilitation per day, 5 days per week for 3 weeks, consisting of activities such as: personalised whole-body exercises (aerobic) on ergometers; resistance training, balneotherapy, therapeutic education, individual and group motivational interviews, nutritional advice, relaxation sessions and psychology sessions). By participating in this study, patients will benefit from this programme as well as 30-minute motor imagery sessions, the content of which will depend on the experimental group to which they are assigned after randomisation.

Participation will also include a visit before the start and after the end of the programme in order to carry out various assessments.

Conditions

• Common Non-specific Low Back Pain

Interventions

OTHER

Assessment

Before and after the programme : * Self-questionnaires: assessment of pain (visual analogue scale), functional disability (Oswestry), kinesiophobia (Tampa scale of Kinesiophobia), mood (Hospital Anxiety Depression Scale), quality of life (SF12), level of physical activity (Simple Physical Activity Questionnaire), and level of motor imagery (Kinesthesic and Visual Imagery Questionnaire-10) * Functional tests: Sorensen test, Shirado test, Time Up and Go test (TUG), 6-minute walk test, 200-metre fast walk test, measurement of maximum isometric strength of back extensors/flexors, 3D analysis of locomotion, posture and trunk flexion. * Evaluation of excitability and inhibition mechanisms within the primary motor cortex at rest and during motor imagery using single and double pulse TMS. Excitability between the brain and the erector spinae muscles and inhibition of the primary motor cortex will be measured at rest and during imagery of back flexion and extension movements

OTHER

Motor imagery task sessions

3 sessions of 30 minutes per week

OTHER

Cognitive task sessions

3 sessions of 30 minutes per week

OTHER

Assessment of satisfaction and tolerance

During the final assessment, which will take place after the programme. Satisfaction and tolerance will be assessed using a visual analogue scale.

Sponsors & Collaborators

• Centre Hospitalier Universitaire Dijon

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

OTHER

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2026-01-22

Primary Completion

2028-03-31

Completion

2028-03-31

Countries

• France

Study Locations