About this trial
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.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
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,
Disqualifiers
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,
Trial design
Parallel
Treatments tested in this trial
conventional exercise + motor imagery without virtual reality
Other interventionParticipants in the control groups will undergo a structured conventional exercise programme under the supervision of a physiotherapist, three days a week for six weeks. The conventional exercise programme has been designed to include stretching, postural control and muscle strengthening components. Each session will last approximately 30 minutes. The intensity and difficulty level of the exercises will be gradually increased every two weeks and progressed in a controlled manner. In the control group, recorded versions of virtual reality games will be presented via a standard monitor screen without the use of a virtual reality headset. Participants will watch each video for three minutes and will then be asked to visualise the same movements for two minutes. The total duration of the motor imagery intervention in the control group will also be 15 minutes.
conventional exercise + motor imagery with virtual reality
Other interventionA structured conventional exercise programme will be implemented three days a week for six weeks. The conventional exercise programme has been designed to include components of stretching, postural control and muscle strengthening. Each session will last approximately 30 minutes. The intensity and difficulty level of the exercises will be gradually increased every two weeks and progressed in a controlled manner. In the experimental group, motor imagery exercises will be performed by creating a virtual environment using the provided virtual reality headset. In this group, a total of three different virtual reality games targeting the upper limbs, trunk and lower limbs will be used. Each game will be viewed for three minutes via the virtual reality headset, after which participants will be asked to mentally visualise the relevant movements for two minutes. The total duration of the motor imagery intervention is planned to be 15 minutes.
Treatment groups
Trial outcomes
Primary outcomes
pain assessment
Pain during rest and activity will be assessed using the VAS. The VAS is a 10-cm scale where 0 points indicate 'no pain' and 10 points indicate 'the worst pain imaginable'. Participants will be asked to mark the scale based on their assessment of pain intensity over the past 24 hours. Pain intensity will be measured using the scale and recorded in centimetres.
pain assessment
Pain during rest and activity will be assessed using the VAS. The VAS is a 10-cm scale where 0 points indicate 'no pain' and 10 points indicate 'the worst pain imaginable'. Participants will be asked to mark the scale based on their assessment of pain intensity over the past 24 hours. Pain intensity will be measured using the scale and recorded in centimetres.
Secondary outcomes
Pressure Pain Threshold Assessment
An algometer will be used to assess the pressure pain threshold. During the assessment, tender points at the occipital base, lower cervical region, trapezius, supraspinatus, second costochondral joint, lateral epicondyle and medial knee border will be measured bilaterally. In addition, the patient will be asked to stand upright so that the tender points of the gluteus and greater trochanter can also be assessed. Each measurement will be repeated three times bilaterally, and the average of the values obtained will be recorded.
Pressure pain threshold assessment
An algometer will be used to assess the pressure pain threshold. During the assessment, tender points at the occipital base, lower cervical region, trapezius, supraspinatus, second costochondral joint, lateral epicondyle and medial knee border will be measured bilaterally. In addition, the patient will be asked to stand upright so that the tender points of the gluteus and greater trochanter can also be assessed. Each measurement will be repeated three times bilaterally, and the average of the values obtained will be recorded.
Galvanic Skin Response
Galvanic skin response is an important physiological parameter that measures changes in the electrical conductivity of the skin surface and reflects sympathetic nervous system activity. It is frequently used as a non-invasive, reliable and sensitive method for assessing autonomic nervous system responses. In this study, galvanic skin response measurements will be carried out using a galvanic skin response sensor to be acquired as part of the project, with the aim of objectively evaluating the effects of a virtual reality-based motor imagery intervention on autonomic physiological responses. The galvanic skin response will be recorded.
Galvanic Skin Response
Galvanic skin response is an important physiological parameter that measures changes in the electrical conductivity of the skin surface and reflects sympathetic nervous system activity. It is frequently used as a non-invasive, reliable and sensitive method for assessing autonomic nervous system responses. In this study, galvanic skin response measurements will be carried out using a galvanic skin response sensor to be acquired as part of the project, with the aim of objectively evaluating the effects of a virtual reality-based motor imagery intervention on autonomic physiological responses. The galvanic skin response will be recorded .
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