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

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

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.

Inclusion Criteria:

• Adult patient
• Person who has given their verbal consent
• Suffering from chronic non-specific low back pain that has been ongoing for more than 6 months
• Eligible for a multimodal rehabilitation programme according to the investigating physician

Exclusion Criteria:

• Persons not affiliated with or not covered by a social security scheme
• Patients subject to legal protection measures (guardianship, curatorship)
• Patients subject to judicial protection measures
• Pregnant women, women in labour or breastfeeding women
• Adults who are incapacitated or unable to give their consent
• Patients with a history of repeated falls
• Scheduled lumbar spine surgery in the coming year
• Associated conditions other than spinal conditions (orthopaedic, neurological, vascular, cardiac, etc.) that could significantly impair mobility
• Radicular involvement (sciatica or cruralgia) with motor deficit < 3 in the lower limbs
• Impaired comprehension skills making self-assessment impossible
• Patients with poorly controlled epilepsy
• Individuals who are not fluent in English
• Patients who have already completed a multimodal rehabilitation programme in a specialised centre