Motor Imagery + Stabilization exercise for Chronic Neck Pain

#023 – Motor Imagery + Stabilization exercise for Chronic Neck Pain

Estimated reading time: 2 minutes, 24 seconds.*

The effect of adding motor imagery to stabilization exercise for chronic neck pain


The authors of this quasi-experimental study, hypothesized that adding the motor imagery intervention to neck stabilization exercise will enhance treatment effects on pain intensity, disability, and kinesiophobia.

?Interventions and groups:

  • Neck stabilization exercise (NSE) group: 24 participant
    • 40 to 50 minutes session/day, 3 days/week for 6 weeks. Sessions consisted of 10 minutes warm-up, 20 to 30 minutes of stabilization exercise and 10 minutes cool-down.
    • Contraction of the deep neck muscle activity using the stabilizer pressure biofeedback unit, at first a slow and controlled craniocervical flexion action in the supine position, progressively increase ranges of craniocervical flexion Stabilizer Pressure Biofeedback placed behind the neck from 20 mm Hg to the final level of 30 mmHg.
    • Cervical bracing technique using the bracing technique in the neurodevelopment phase (prone, supine, 151 bipedal, quadrupedal) for the cervical spine, hold time was 10 seconds in each position for 8 then progressed to 10 repetitions.
    • Cervical isometric exercise using elastic resistance band in forward, toward the right and left, obliquely, and directly backward directions, 6 to 10 seconds hold for 10 repetitions.
  • Motor imagery group (MI+NSE): 24 participant
    • 10 repetitions/movement, 25 minutes, 3 days/week for 6 weeks.
    • Week 1&2, kinesthetic imagery (the state of feeling a motion):
      • Using the same NSE protocol, participants were asked to feel their body parts without any movement, then asked to imagine the movement by showing NSE and auditive precise instructions for each movement.
      • Next, they were instructed to perform a guided mental task of visual-motor imagery.
      • Guided by the therapists, participants were asked imagine the neck stabilization exercise, trying to form a visual mental image or picture of movements and attempting to visualize the motion as clear and vivid as possible.
    • Week 3&4, internal visual imagery (motion is visualized within the body by seeing the extremity’s body):
      • Participants were shown the NSE on a monitor and by a therapist and were asked mentally review the exercises and to focus on how to properly perform the movements.
    • Week 5&6, external visual imagery (Seeing ones self from the outside):
      • Participants performed NSE in front of a mirror.

Control group: 24 participant, no intervention.


  • Pain intensity: Measured using the Visual Analogue Scale (VAS)
    • Both experimental groups reduced pain.
    • The MI+NSE showed a significantly greater reduction in pain compared to the NSE alone group and the control group.
  • Disability: measured using the Neck Disability Index (NDI)
    • Both experimental groups reduced NDI.
    • The MI+NSE group showed a significantly greater reduction in NDI compared to the NSE alone group and the control group.
  • Kinesiophobia: measured using Tampa Scale of kinesophobia (TSK)
    • Both experimental groups reduced TSK.
    • The MI+NSE group showed a significantly greater reduction in TSK compared to the NSE alone group and the control group.


  • This trial was done on chronic non-specific neck pain participants, with moderate pain intensity and moderate disability.
  • Neck stabilization exercise combined with motor imagery can decrease pain, disability, and kinesiophobia for chronic non-specific neck pain.


  • People that searched for neck pain also searched for Sternocleidomastoid muscle (PT students ?).

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*Calculation is based on the average reading speed that around 200 words per minute (wpm).

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