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Published on: April 20, 2019
Effect of Telerehabilitation-Based Motor Imagery Training on Pain and Related Factors in People With Multiple
Hilal Karakas1, Turhan Kahraman2, Asiye Tuba Ozdogar3
1Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul Bilgi University, Istanbul, Turkey; Graduate School of Health Sciences, Department of Physiotherapy and Rehabilitation, Izmir, Dokuz Eylul University, Turkey; Graduate School of Health Sciences, Department of Physiotherapy and Rehabilitation, Izmir Katip Celebi University, Izmir, Turkey.
Objectives:
To investigate the effect of telerehabilitation-based graded motor imagery (MI, GMI) training on pain and pain-related factors in people with multiple sclerosis (MS).
Design:
Randomized controlled, assessor-blind pilot trial with repeated-measure design.
Setting:
Neurology outpatient clinic.
Participants:
Thirty-two people with MS were randomly allocated to intervention (n=16) and control (n=16) groups.
Interventions:
During the 8-week GMI training period, the first 2 weeks involved implicit MI training while 6 weeks of explicit MI training were conducted.
Main Outcome Measures:
The primary outcome was the general pain intensity over the past 2 days, assessed with a visual analog scale, with a minimum clinically important difference (MCID) of 23 mm. Secondary outcomes included general pain and specific body parts' pain intensity over the past 7 days, neuropathic pain intensity, MI ability, fatigue, depression, anxiety, quality of life, sleep quality, daytime sleepiness, and cognitive functions scores. Assessments were conducted at baseline, at weeks 8 (post-treatment) and 12 (follow-up).
Results:
The intervention group demonstrated a significant reduction in pain intensity over the past 2 days compared with control group (P<.05). Furthermore, at the 8-week assessment, the intervention group surpassed the MCID in pain intensity over the past 2 and 7 days (P<.05), whereas no significant change was observed in the control group (P>.05). Significant effects were observed post-treatment on general pain over the past 7 days, neuropathic pain, MI ability, fatigue, depression, quality of life, processing speed, and visuospatial memory within intervention group compared with control group (P<.05). However, the effect on anxiety, sleep quality, daytime sleepiness, and verbal memory between groups was not significant (P>.05).
Conclusions:
Telerehabilitation-based GMI training stands out as viable for the management of chronic pain and pain-related psychosocial symptoms for people with MS.
