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Differential changes in cervical proprioception and motor imagery following structured imagery training in chronic neck pain

Year: 2026

Type: article

Abstract: BACKGROUND: Chronic neck pain (CNP) is associated with altered sensorimotor function, including impairments in cervical proprioception and changes in body-related perception. While implicit motor imagery (IMI)-based interventions have shown clinical benefits, their effects on cervical proprioceptive performance and motor imagery-related outcomes in individuals with CNP remain unclear. OBJECTIVE: To investigate the effects of lateralization and IMI training on cervical proprioception (CP), neck awareness (NA), IMI performance, pain, disability, kinesiophobia, and range of motion (ROM) in individuals with CNP. METHODS: In this clinical trial, 34 participants (17 CNP, 17 healthy controls) completed a 4-week structured imagery training (SIT) program combining lateralization and IMI training delivered via telerehabilitation. Primary outcome was cervical joint position error (JPE). Secondary outcomes included IMI performance (left/right judgment task), pain, disability, kinesiophobia, NA, ROM, and cognitive interference (Stroop). RESULTS: Following SIT, the CNP group showed statistically significant within-group reductions in pain intensity (Holm-adjusted p = 0.012, d = 0.76), kinesiophobia (Holm-adjusted p = 0.034, d = 0.50), neck-related disability (Holm-adjusted p = 0.034, d = 0.37), and FreNAQ-T scores (Holm-adjusted p = 0.012, d = 0.09). However, baseline-adjusted models revealed no statistically significant between-group post-training differences for extension JPE (p > 0.05, partial η2 = 0.009), flexion JPE (where post-training values remained persistently elevated in CNP; partial η2 = 0.310), and IMI accuracy/reaction times for neck and hand tasks (all Holm-adjusted p = 1.000, partial η2 ≤ 0.068). CONCLUSIONS: A 4-week SIT program was associated with short-term improvements in subjective clinical symptoms in individuals with CNP; however, no differential group effects were observed for objective cervical proprioception or motor imagery performance.

Source: PLoS ONE

DOI: 10.1371/journal.pone.0361409

Authors: Aysegul Bostan, Aysenur Akan, Ozlem Ulger

Institutions: Bahçeşehir University, Hacettepe University, Istanbul Medipol University

Language: English

Topic: Musculoskeletal pain and rehabilitation

Subfield: Physical Therapy, Sports Therapy and Rehabilitation

Field: Health Professions

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,382