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Accepted for/Published in: JMIR Research Protocols

Date Submitted: Oct 9, 2025
Date Accepted: Feb 24, 2026

The final, peer-reviewed published version of this preprint can be found here:

Motor Imagery and Action Observation in Breast Cancer Survivors: Protocol for a Randomized Controlled Trial

Arnal-Vallés MP, Soto-Ruiz N, BAYS-MONEO AB, García-Vivar C, Escalada-Hernández P

Motor Imagery and Action Observation in Breast Cancer Survivors: Protocol for a Randomized Controlled Trial

JMIR Res Protoc 2026;15:e85469

DOI: 10.2196/85469

PMID: 41911468

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

Motor Imagery and Action Observation in Breast Cancer Survivors: A Study Protocol

  • María Pilar Arnal-Vallés; 
  • Nelia Soto-Ruiz; 
  • Ana Beatriz BAYS-MONEO; 
  • Cristina García-Vivar; 
  • Paula Escalada-Hernández

ABSTRACT

Background:

Breast cancer is the most common type of cancer in women worldwide, and its incidence is increasing. Although breast cancer survival is slowly increasing, related sequelae can persist after the disease has been treated. The main physical symptoms associated with breast cancer include pain, lymphedema and associated functional limitations. Although multiple treatments are available for alleviating symptoms in breast cancer survivors, their effectiveness remains limited. Motor imagery (MI) and action observation (AO) therapies, which are based on the theory of motor simulation and are used in multiple fields with satisfactory results, have been proposed as alternatives for treating pain and improving mobility and strength.

Objective:

To design, implement and evaluate the effectiveness of a program combining MI therapies and AO to improve functionality, mobility and alleviate pain and lymphedema of the affected upper limb in women who have survived breast cancer

Methods:

A randomized controlled clinical study will be conducted in a sample of 108 participants who have experienced breast cancer and, as a result, have pain in the affected extremity, lymphedema or loss of strength and/or mobility. The intervention group will include 54 participants managed with the MIAO program (a combination of motor imagery, action observation and mobility exercises), while the control group will consist of 54 women performing mobility exercises alone. Pain intensity, muscle strength, joint range, limb diameter, fear of movement and imagery capability will be evaluated.

Results:

The intervention is expected to yield improvements in pain intensity, joint range, muscle strength and symptoms associated with lymphedema, among other outcomes

Conclusions:

The implementation of an intervention based on motor imagery and action observation has the potential to positively impact female breast cancer survivors who face physical and psychological sequelae that interfere with their daily lives. Clinical Trial: has been registered on ClinicalTrials.gov (Number NCT07067710)


 Citation

Please cite as:

Arnal-Vallés MP, Soto-Ruiz N, BAYS-MONEO AB, García-Vivar C, Escalada-Hernández P

Motor Imagery and Action Observation in Breast Cancer Survivors: Protocol for a Randomized Controlled Trial

JMIR Res Protoc 2026;15:e85469

DOI: 10.2196/85469

PMID: 41911468

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