Graded Motor Imagery for Primary Dysmenorrhea

Summary

The goal of this clinical trial is to learn if graded motor imagery can reduce pain sensitivity and period pain in women with primary dysmenorrhea (painful periods with no medical cause).

The main questions it aims to answer are:

1. Is there a decrease in pressure pain threshold (increased pain sensitivity) with graded motor imagery?
2. Is the intensity of menstrual pain reduced by graded motor imagery?
3. Is GMI helpful to reduce menstrual symptoms and pain catastrophizing (negative thinking about pain)?

Researchers will compare full GMI (active intervention), a sham GMI(inactive intervention), and a wait-list (no intervention) to see if GMI works better than the alternatives.

Participants will:

1. Take part in a 6-week graded motor imagery program, sham program, or no intervention control.
2. Do laterality recognition, motor imagery, and mirror therapy exercises in the graded motor imagery group.
3. Complete pain and symptom assessments before and after the program, and again at follow-up.

Conditions

• Primary Dysmenorrhea (PD)

Interventions

BEHAVIORAL

Graded Motor Imagery (GMI)

The intervention will be a structured 6-week graded motor imagery program focused on the modulation of pain processing and sensorimotor representation in women with primary dysmenorrhea. It will consist of three sequential steps. Firstly, laterality recognition training with pelvic and abdominal body images. Secondly, explicit motor imagery with pain-free abdominal and pelvic movements. Finally, mirror therapy/visual feedback for normal pain-free movement. The program will be delivered online by a trained physiotherapist with two supervised sessions per week as well as daily home practice. This intervention is different from usual exercise or education because it mainly focuses on the cortical and sensorimotor mechanisms rather than only physical conditioning.

BEHAVIORAL

Sham Graded Motor Imagery

The intervention will be a sham 6-week graded motor imagery program in which the participants will undergo a program of the same amount of contact time as well as duration over 6 weeks with the same number of sessions. The sham intervention will consist of three phases. Sham laterality discrimination tasks will be performed with distal body parts only (e.g., hands and feet) and without pelvic content. Moreover, the sham general relaxation imagery will have peaceful scenes rather than body movement. Lastly, sham mirror exposure will be done by looking at a mirror showing the contralateral hand but not at the pelvic area. The sham protocol aims to control non-specific effects of therapist contact, attention, and imagery engagement, and to remove the pelvic-specific cortical engagement as occurred in the active component of GMI.

Sponsors & Collaborators

• University of Health Sciences Lahore

  collaborator OTHER

• Dr. Mehak Naeem

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

30 Years

Sex

FEMALE

Healthy Volunteers

No

Timeline & Regulatory

Start

2026-04-06

Primary Completion

2026-08-31

Completion

2026-08-31

Countries

• Pakistan

Study Locations