Effect of Motor Imagery and Conventional Exercises on Pain and Disability in Subjects with Chronic Mechanical Back Pain

Abstract
Background: Chronic mechanical back pain is a prevalent musculoskeletal disorder that
significantly impacts quality of life by increasing pain, disability, and psychological distress.
Conventional exercise therapy is a widely accepted treatment; however, newer approaches like
MI have shown potential in enhancing rehabilitation outcomes by targeting both physical and
psychological components of pain.
Objective: The objective of this study was to evaluate and compare the effects of MI and
conventional exercises on pain intensity, functional disability, and psychological inflexibility in
subjects with chronic mechanical back pain.
Research Methodology: A total of 40 participants with chronic mechanical back pain were
randomly assigned to either an MI group or a conventional exercise group. Interventions were
administered over four weeks. Pain intensity was assessed using the NPRS, functional disability
was measured through the MODI, and psychological inflexibility was evaluated using the PIPS.
Data normality was assessed using the Shapiro-Wilk test. Within-group and between-group
analyses were conducted using paired t-tests and Mann-Whitney U tests respectively. Post-hoc
power analysis and MCID calculations were also performed.
Results: Both groups demonstrated significant within-group improvements in NPRS, MODI,
and PIPS scores after four weeks (p < 0.05), with changes exceeding the MCID thresholds,
indicating clinically meaningful benefits. However, between-group comparisons showed no
statistically significant differences in outcomes (p > 0.05). Post-hoc analysis revealed adequate
power for NPRS but lower power for MODI and PIPS.
Conclusion: MI was found to be an effective intervention in reducing pain, improving
disability, and enhancing psychological flexibility in individuals with chronic mechanical back
pain. Although no statistically significant differences were observed when compared to
conventional exercises, the clinical improvements confirm that MIcan be effectively
incorporated into rehabilitation programs. Future studies with larger sample sizes and longer
follow-up periods are recommended to further validate these findings.
Keywords: Chronic back pain, Motor imagery, Conventional exercises, Pain management,
Disability, Psychological Status