The rehabilitative role of motor imagery in the treatment of pain in fibromyalgia syndrome: Preliminary results

Abstract

FM is a prototypical form of central sensitization syndrome that affects the dysregulation of mechanisms that normally govern pain sensation and should have to be treated in a multidisciplinary approach, which entails physical exercise, multimodal cognitive behavioral therapy, and pharmacological therapy. The aim of this research is to investigate whether a neurocognitive rehabilitative approach based on the use of motor imagery (MI) could be efficacy in reducing chronic pain in FM. Furthermore, as a secondary outcome, we assess the efficacy of MI on the improvement in the recognition and awareness respect pain by EEG. Ten females (mean age 51 ± 6.1 years) with FM were recruited and performed ten rehabilitation sessions, twice a week lasting one hour, using the motor imagery. The following evaluation scales were used at the baseline (T0), after treatment (T1) and after two months of follow-up (T2): the Fibromyalgia Impact Questionnaire (FIQ), the Visual Analogue Scale (VAS), the Fibromyalgia Assessment Status (FAS) and the Health Assessment Questionnaire (HAQ), the SF-12 was administered to assess the quality of life. The EEG was used to record cortical activation with respect to recognize pictures divided into “algic” and “non-algic”, versus a control group of healthy women. By Mann–Whitney test, at baseline, by EEG there is a statistically significant difference in the recognition of “algic” images compared to “non-algic” ones between the FM group and the healthy group ( P < 0.05): this difference is not found after the rehabilitative treatment. In the FM group there is a statistically significant improvement for FIQ, FAS, VAS ( P < 0.05) and SF-12. Follow-up dates are still ongoing. A neurocognitive rehabilitation approach with motor imagery improves the recognition and perception of pain in the FM patient and is efficacy in reducing pain and improving related symptoms.