Exercise, Motor Imagery, and Pain Neuroscience Education for Primary Dysmenorrhea: A Randomized Trial
Comparison of the Effects of Exercise, Motor Imagery Training, and Pain Neuroscience Education on Pain, Menstrual Symptoms, and Cognitive Flexibility in Women With Primary Dysmenorrhea: A Randomized Controlled Trial
Muge Dereli
51 participants
Feb 25, 2025
INTERVENTIONAL
Conditions
Summary
The goal of this clinical trial is to find out whether exercise, motor imagery training, and pain neuroscience education can help reduce menstrual pain and improve well-being in young women with primary dysmenorrhea. The study will also look at how these approaches affect menstrual symptoms, movement control, and cognitive flexibility. The main questions it aims to answer are: * Does adding motor imagery or pain neuroscience education to an exercise program reduce pain and menstrual symptoms more than exercise alone? * Do these approaches improve movement control, thinking flexibility, and knowledge about pain? Researchers will compare three groups: * Exercise only * Exercise plus motor imagery training * Exercise plus pain neuroscience education Participants will: * Attend supervised exercise sessions twice a week for 8 weeks * Practice either motor imagery or receive short pain neuroscience education, depending on their group * Complete questionnaires and tests before and after the program, during the first three days of menstruation
Eligibility
Inclusion Criteria7
- Female, aged 18-25 years
- Gynecological examination and ultrasound confirming absence of pelvic pathology
- History of primary dysmenorrhea for at least 6 months, with pain intensity ≥4 on the Numeric Rating Scale (0-10) during the first 3 days of menstruation
- Regular menstrual cycles (21-35 days)
- Nulliparous (no history of pregnancy or childbirth)
- No systemic, metabolic, rheumatologic, or lumbar pathology
- Willingness to participate in the 8-week intervention program and attend follow-up assessments
Exclusion Criteria9
- Diagnosis of secondary dysmenorrhea (e.g., endometriosis, pelvic inflammatory disease, uterine fibroids, ovarian cysts)
- Current pregnancy or planning to become pregnant during the study period
- History of pelvic or abdominal surgery
- History of sexually transmitted diseases
- Current use of antidepressants, anxiolytics, or hormonal therapy (e.g., oral contraceptives, intrauterine device)
- Known neurological, psychiatric, or systemic musculoskeletal disorders
- Cognitive impairment or attention deficit that may interfere with participation
- Participation in regular exercise in the last 6 months
- Use of alternative therapies for dysmenorrhea (e.g., acupuncture, massage)
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Interventions
Participants will complete an 8-week supervised exercise program, delivered twice per week. The program includes lumbopelvic stabilization, stretching, and endurance training exercises designed to reduce menstrual pain and improve physical function.
Participants will complete the same 8-week supervised exercise program as the Exercise Only group. In addition, they will practice kinesthetic motor imagery of the prescribed movements prior to performing them, aiming to enhance motor control and pain modulation.
Participants will complete the same 8-week supervised exercise program as the Exercise Only group. In addition, they will receive weekly face-to-face pain neuroscience education sessions focused on pain neurophysiology, supported with home assignments to reinforce learning.
Locations(1)
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NCT07196150