Effects of motor imagery using virtual reality on pain sensitivity and affect in healthy individuals: a prospective randomized crossover study

Abstract

Objective Exercise induces a hypoalgesic response and improves affect. However, some individuals are unable to exercise for various reasons. Motor imagery, involving kinesthetic and visual imagery without physical movement, activates brain regions associated with these benefits and could be an alternative for those unable to exercise. Virtual reality also enhances motor imagery performance because of its illusion and embodiment. Therefore, we examined the effects of motor imagery combined with virtual reality on pain sensitivity and affect in healthy individuals. Design Randomized crossover study. Setting Laboratory. Subjects Thirty-six participants (women: 18) were included. Methods Each participant completed three 10-min experimental sessions, comprising actual exercise, motor imagery only, and motor imagery combined with virtual reality. Hypoalgesic responses and affective improvement were assessed using the pressure–pain threshold and the Positive and Negative Affect Schedule, respectively. Results All interventions significantly increased the pressure–pain threshold at the thigh (P<0.001). Motor imagery combined with virtual reality increased the pressure–pain threshold more than motor imagery alone, but the threshold was similar to that of actual exercise (both P≥0.05). All interventions significantly decreased the negative affect of the Positive and Negative Affect Schedule (all P<0.05). Conclusions Motor imagery combined with virtual reality exerted hypoalgesic and affective-improvement effects similar to those of actual exercise.