Open AccessInfluence of the Generation of Motor Mental Images on Physiotherapy Treatment in Patients with Chronic Low Back Pain
Author(s) -
Mónica Grande-Alonso,
Miriam Garrigós-Pedrón,
Ferrán CuencaMartínez,
Celia Vidal-Quevedo,
María Prieto-Aldana,
Roy La Touche,
Alfonso Gil-Martínez
Publication year - 2020
Publication title -
pain physician
Language(s) - English
Resource type - Journals
eISSN - 2150-1149
pISSN - 1533-3159
DOI - 10.36076/ppj.2020/23/e399
Subject(s) - medicine , physical therapy , lumbar , kinesthetic learning , motor imagery , randomized controlled trial , physical medicine and rehabilitation , low back pain , surgery , psychology , electroencephalography , pathology , psychiatry , developmental psychology , brain–computer interface , alternative medicine
generating kinesthetic and visual motor imagery.Objectives: The main aim of this study was to determine whether the ability to generatemental motor imagery (MIab) influences psychological, motor, and disability variables in patientswith NCLBP. The secondary aim was to determine whether an approach based on therapeuticexercise (TE) and therapeutic education (TEd) could improve the MIab in those patients with lessability to perform it.Study Design: Cross-sectional and quasiexperimental study.Setting: Physical Therapy Unit of primary health care center in Madrid, Spain.Methods: A total of 68 patients were divided into 2 groups according to a greater (n = 34)or lesser (n = 34) MIab. Treatment was based on TEd and TE for the group with less ability togenerate kinesthetic and visual motor imagery. The outcome measures were imagery requestedtime, self-efficacy, disability, pain intensity, lumbar strength, psychological variables, and MIab.Results: The group with lesser MIab showed lower levels of self-efficacy (P = 0.04; d, −0.47)and lower levels of lumbar strength and extension strength (P = 0.04; d, −0.46 and P = 0.02; d,−0.52, respectively). After the intervention with TE and TEd, MIab (both kinesthetic and visual)improved significantly, with a moderate to large effect size (P ≤ 0.01; d, −0.80 and P ≤ 0.01; d,−0.76, respectively), as did pain intensity, lumbar strength, disability, and psychological variables(P 0.05). Based on the results, the patients with NCLBPwith lesser MIab achieved lower levels of self-efficacy and lower strength levels.Limitations: The results of this study should be interpreted with caution because of itsquasiexperimental design and a bias selection.Conclusions: A clinical TE approach, coupled with a TEd program, resulted in significantimprovement in MIab (both kinesthetic and visual), reduced pain intensity, increased lumbarstrength, reduced disability, and improved psychological variables, but it did not significantlyimprove self-efficacy levels in the patients with NCLBP.Key words: Chronic low back pain, motor imagery, disability, lumbar strength