Virtual Reality-Based Motor Imagery for Individuals With Low Imagery Ability: A Pilot Investigation of Isokinetic Strength and Electromyographic Activity

March 6, 2026 updated by: Burak Alperen Ünsal, Ege University
Motor imagery is a cognitive technique in which individuals mentally rehearse a movement without physically performing it. However, individuals with low imagery ability may not fully benefit from traditional motor imagery training. Virtual reality (VR) may enhance imagery vividness by providing immersive visual feedback. The purpose of this study is to compare the effects of immersive VR-based motor imagery, action observation combined with motor imagery, kinesthetic motor imagery alone, and a control condition on imagery ability, muscle strength, and muscle activation. Thirty-two healthy male participants will be assigned to one of four parallel groups based on imagery ability levels. All participants will complete a 4-week unilateral leg extension resistance training program (three sessions per week at 80% of one-repetition maximum). During each session, participants will perform their assigned imagery protocol. Primary outcomes include changes in imagery ability assessed by the Movement Imagery Questionnaire-3. Secondary outcomes include isokinetic quadriceps peak torque, average power, and surface electromyography activity of the rectus femoris, vastus medialis, and vastus lateralis muscles. The findings of this study may provide insight into whether immersive VR can enhance the effectiveness of motor imagery training in individuals with low imagery ability.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Motor imagery training has been shown to enhance motor performance and strength adaptations; however, its effectiveness is strongly influenced by individual imagery ability. Individuals with low imagery ability may experience limited benefits due to reduced vividness and sensory engagement during mental rehearsal. Immersive virtual reality (VR) may enhance the perceptual and sensory components of imagery by providing first-person visual feedback, thereby potentially improving motor-related neural activation and training adaptations. This study is designed as a 4-week, parallel-group interventional trial including healthy young adult males. Participants will be categorized according to imagery ability assessed by the Movement Imagery Questionnaire-3 (MIQ-3) and allocated into four groups: immersive VR-based motor imagery, action observation combined with motor imagery, kinesthetic motor imagery alone, and a control condition involving relaxation imagery. All participants will complete a supervised unilateral leg extension resistance training program performed three times per week at 80% of one-repetition maximum. Each session will consist of four sets of 8-12 repetitions for the dominant leg. Imagery interventions will be administered prior to each training session according to group assignment. Isokinetic strength assessments will be performed at angular velocities of 60°/s and 120°/s. Surface electromyography (sEMG) signals will be recorded from the rectus femoris, vastus medialis, and vastus lateralis muscles during testing. Imagery ability will be reassessed following the intervention period. The primary objective of the study is to determine whether immersive VR-based motor imagery enhances imagery ability and neuromuscular adaptations compared to traditional motor imagery approaches and control conditions.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
32

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Healthy male individuals aged 18-30 years No participation in a structured lower-limb resistance training program within the previous 6 months No prior experience with structured motor imagery training Provided written informed consent

Exclusion Criteria:

  • History of lower-limb musculoskeletal injury or surgery within the past 6 months Neurological disorders affecting motor control Visual or vestibular impairments preventing safe use of virtual reality equipment Current use of medications affecting neuromuscular performance Any medical condition contraindicating resistance training

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Basic Science
  • Allocation: Non-Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Action Observation + Motor Imagery (AOMI)
Participants perform action observation combined with kinesthetic motor imagery prior to each resistance training session for 4 weeks.
Behavioral: Action Observation + Motor Imagery
Participants observe a video demonstration of unilateral leg extension while simultaneously performing kinesthetic motor imagery of the movement prior to each resistance training session, three times per week for four weeks.
Experimental: Kinesthetic Motor Imagery
Participants perform kinesthetic motor imagery alone prior to each resistance training session for 4 weeks.
Behavioral: Behavioral: Kinesthetic Motor Imagery
Participants perform kinesthetic motor imagery of unilateral leg extension without visual assistance prior to each resistance training session, three times per week for four weeks.
Active Comparator: Control
Participants perform relaxation imagery prior to each resistance training session for 4 weeks.
Behavioral: Relaxation Imagery (Control)
Participants perform relaxation-based imagery unrelated to strength training prior to each resistance training session, three times per week for four weeks.
Experimental: Immersive Virtual Reality-Based Motor Imagery
Participants perform immersive first-person virtual reality-based motor imagery prior to each training session. The VR environment provides visual simulation of unilateral leg extension movements from a first-person perspective. The intervention is administered three times per week for 4 weeks before resistance training.
Behavioral: Immersive Virtual Reality-Based Motor Imagery

VR Motor Imagery - Intervention Description

Participants perform immersive first-person virtual reality-based motor imagery prior to each training session. The intervention is administered three times per week for 4 weeks before resistance training.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Change in Imagery Ability (MIQ-3 Total Score)
Time Frame: Baseline to 4 Weeks
Imagery ability will be assessed using the Movement Imagery Questionnaire-3 (MIQ-3). The total score change from baseline to post-intervention will be analyzed.
Baseline to 4 Weeks

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Isokinetic Quadriceps Strength (60°/s, 120°/s)
Time Frame: Baseline to 4 Weeks
Concentric isokinetic quadriceps peak torque will be assessed using an isokinetic dynamometer at angular velocities of 60°/s and 120°/s. Average power (Ap) and body mass-normalized peak torque (Nm/kg) will be recorded for the dominant leg. The change from baseline to post-intervention will be analyzed.
Baseline to 4 Weeks
Surface EMG Activity (%MVIC)
Time Frame: Baseline to 4 Weeks
Surface electromyography (sEMG) activity of the rectus femoris, vastus medialis, and vastus lateralis muscles will be recorded during concentric isokinetic quadriceps testing. EMG signals will be processed and normalized to maximal voluntary isometric contraction (MVIC) values. Changes in normalized EMG amplitude (%MVIC) from baseline to post-intervention will be analyzed.
Baseline to 4 Weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Ege University

Collaborators

Collaborators

An organization other than the sponsor that provides support for a clinical study. This support may include activities related to funding, design, implementation, data analysis, or reporting.
The Scientific and Technological Research Council of Turkey

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
August 12, 2025

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
December 25, 2025

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
January 20, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
March 3, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
March 6, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
March 10, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
March 10, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
March 6, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
March 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 24-10.2T/4

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

De-identified individual participant data (IPD) underlying the primary and secondary outcome measures, including MIQ-3 scores, isokinetic peak torque values, average power, and normalized sEMG data, will be shared. Demographic variables necessary for replication (age and body mass) will also be included.

IPD Sharing Time Frame

Data will be available beginning 6 months following publication of the primary results and will remain available for 5 years.

IPD Sharing Access Criteria

Access to de-identified individual participant data will be granted to qualified researchers upon reasonable request to the corresponding author. Requests must include a brief research proposal outlining the intended use of the data. Data will be shared following approval by the study investigators and in accordance with institutional and ethical guidelines.

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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