JMIR Publications

ABSTRACT

Background:

Background:

Chronic musculoskeletal pain (MSP), particularly in obese patients, poses significant challenges due to increased pain sensitivity, reduced mobility, and systemic inflammation. Obesity aggravates mechanical constraints on the joints and increases systemic inflammation, exacerbating certain medical conditions and making conventional therapeutic approaches less likely to succeed Conventional therapies often show limited efficacy, necessitating innovative approaches. This pilot study evaluates the short-term effectiveness of a mindfulness and motor imagery-based intervention delivered via an app, on pain, functionality, and quality of life in obese patients with chronic knee pain.

Objective:

The objective was to assess the efficacy of an app based therapy to relieve chronic knee pain in an obese population

Methods:

Methods:

A prospective, single-centre study was conducted over one month including 30 patients (BMI >30) experiencing chronic knee pain (≥3 months) without surgery needed. Patients underwent two video-guided motor imagery sessions, focusing on neuromuscular reactivation (NMR). Functional scores, including SANE, KOOS, and SF-36, were assessed pre- and post-intervention. Paired t-tests analysed score improvements, with p < 0.05 deemed significant.

Results:

Results:

Significant improvements were observed across all parameters. The mean overall SANE score improved by 51% (p < 0.001). The minimal clinically important difference (MCID), was therefore approximately 6.7 points. The observed mean improvement (25 points) exceeded this threshold by more than threefold, indicating a clinically meaningful improvement in functional status. The KOOS score increased by 56% (p < 0.001). SF-36 scores showed substantial enhancements in both physical (+66%, p < 0.001) and mental components (+36%, p < 0.001). Patient satisfaction with this method was rated 4.5/5, and no adverse effects were reported.

Conclusions:

Conclusion: This method demonstrated significant efficacy in reducing pain and improving functionality and quality of life in obese patients with chronic knee pain. By targeting central neuromuscular circuits through guided visualization exercises, this non-invasive intervention addresses central activation dysfunction (CAD), a proposed novel concept in neuromuscular disorders which originates from hypotheses derived from clinical observations. This interesting concept requires further exploration to ensure its neurophysiological validation through future studies with larger sample sizes, control groups, and long-term follow-ups which could explore CAD as a therapeutic target.