Virtual Reality-based Motor Imagery in Patients With Fibromyalgia

The Effect of Virtual Reality-Based Motor Imagery on Pain, Psychological Status and Quality of Life in Fibromyalgia Patients

This study investigated the effects of a virtual reality-based motor imagery intervention integrated into a conventional exercise programme on pain outcomes (pain intensity, central sensitisation, pressure pain threshold, galvanic skin response, pain catastrophising), quality of life, sleep quality, fatigue, psychological outcomes (Hospital Anxiety and Depression Scale), imagery ability and patient satisfaction.

The study will include individuals aged 18-60 who have been diagnosed with fibromyalgia. Participants will be randomly assigned to one of two groups using a sealed-envelope method: the traditional exercise + virtual reality-assisted motor imagery group, or the traditional exercise + non-virtual reality motor imagery group. In both groups, participants will undergo a traditional rehabilitation programme three days a week under the supervision of a physiotherapist. In the experimental group, three virtual reality games targeting the upper extremities, trunk and lower extremities will be shown for three minutes each, followed by two minutes of motor imagery. In the control group, the same protocol will be carried out via a monitor without virtual reality. All assessments will be conducted before treatment and at the end of 6 weeks. Pain intensity, Visual Analogue Scale; central sensitivity, Central Sensitivity Inventory; pain catastrophising, Pain Catastrophising Scale; general quality of life, Fibromyalgia Impact Questionnaire; pressure pain threshold, algometer; sleep quality, Pittsburgh Sleep Quality Index; fatigue severity, Fatigue Severity Scale; psychological state, Hospital Anxiety and Depression Scale; patient satisfaction, Patient's General Impression of Change Scale; and imagery ability, Kinesthetic and Visual Imagery Questionnaire-10.

Inclusion Criteria:

• To be a volunteer,
• To have been diagnosed with fibromyalgia according to the 2016 ACR diagnostic criteria,
• To be aged between 18 and 60,
• To have had pain symptoms for at least 3 months,
• To be receiving standard medical treatment,

Exclusion Criteria:

• The presence of neurological or orthopaedic conditions that would prevent participation in the rehabilitation programme
• Pregnancy,
• The presence of cognitive impairments that could affect cooperation,
• The presence of serious, uncontrolled health problems,
• A history of lower limb or spinal surgery
• Visual or hearing impairments;
• Serious psychiatric disorders
• A diagnosis of migraine
• Regular physical exercise in the last three months (≥2 days per week)
• Participation in any concurrent physiotherapy or rehabilitation intervention