Graded Motor Imagery Effects on Body Perception Disturbance in Complex Regional Pain Syndrome : a Randomised Controlled Trial (Bath-Min)

September 8, 2026 updated by: Nantes University Hospital

Complex Regional Pain Syndrome (CRPS) is a debilitating pain condition that usually develops following trauma. Patients with CRPS experience intense, continuing, disproportionate pain and multiple symptoms such as changes or asymmetry in colour, temperature or oedema, as well as stiffness, tremors or dystonia and body perception disturbances. Body perception disturbances are now recognised as part of the typical presentation of CRPS and have been shown to correlate, in particular, with pain intensity.

Managing CRPS is challenging and treatment options are limited. Among these, treatments aimed at cortical reorganisation, such as Graded Motor Imagery (GMI), have shown evidence of efficacy in terms of pain and function. However, with regard to body perception disorders, the evidence is limited and emerging.

Our aim is to evaluate the effects of Graded Motor Imagery on body perception disorders in patients with upper limb CRPS. Method: a randomised controlled trial comparing an intervention group - therapeutic exercises plus GMI for 6 weeks (implicit motor imagery, explicit motor imagery followed by mirror therapy) - with a control group - therapeutic exercises plus sham-GMI (non-motor mental imagery) for 6 weeks.

Outcome measures: body perception disorders (Bath Scale), pain intensity (Numerical Rating Scale), quality of life (PROMIS 29), catastrophising (PCS), fear of pain, CRPS Severity Score, patient-reported global impression of change, medication use and self-efficacy. Interventions are carried out in private practice by independent physiotherapists. Assessors are blinded for the primary outcome. A qualitative component will explore the experiences and perceptions of patients and therapists regarding body perception disturbances, GMI and participation in a research project.

This study aims are to improve treatment options for the management of SDRC and to improve the recognition and treatment of body perception disorders in SDRC.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

80

Phase

  • 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 Contact

Study Locations

  • France
      • Ambon, France, 56190
        • Cabinet de kinésithérapie AMBON 56190 3b route de Lauzach
        • Contact:
        • Principal Investigator:
          • Amaury BRIDOUX, Physical therapist
      • Caen, France, 14000
        • Cabinet de kinésithérapie, CAEN 14000 41 av. père Charles de Foucauld
        • Contact:
        • Principal Investigator:
          • Guillaume GALLIOU, Physical therapist
      • Cugand, France, 85610
        • Cabinet de kinésithérapie, 85610 CUGAND 19bis rue du président auguste durand
        • Contact:
        • Principal Investigator:
          • Victor DUPONT, Physical therapist
      • Guidel, France, 56520
        • Cabinet de kinésithérapie, 56520 6 place Louis le Montagner
        • Contact:
        • Principal Investigator:
          • Germain PICHOT, Physical therapist
      • L'Île-Rousse, France, 20220
        • Cabinet de kinésithérapie, 20220 L'ILE ROUSSE 8 Bd Pasquini
        • Contact:
        • Principal Investigator:
          • FLORIAN SANTOS
      • Lyon, France, 69008
        • Cabinet de kinésithérapie, 69008 LYON 16 rue du transvaal
        • Contact:
        • Principal Investigator:
          • Aissaoui TESSADIT, Physical therapist
      • Montpellier, France, 34000
        • Cabinet de kinésithérapie, 34000 Montpellier, 22, avenue du Pont Juvénal
        • Contact:
        • Principal Investigator:
          • Fabrice ERNOUL, Physical therapist
      • Nantes, France, 44000
        • Cabinet de kinésithérapie du Mail Pablo Picasso, 5 Rue Nina Simone,
        • Contact:
        • Principal Investigator:
          • Sessi ACAPO, Doctor of Science
      • Nantes, France, 44100
        • Cabinet de kinésithérapie, 44100 NANTES 7 RUE DU SIMOUN
        • Contact:
        • Principal Investigator:
          • Clotilde SANDER, Physical therapist
      • Nantes, France, 44100
        • cabinet de kinésithérapie, 44100 NANTES 8ter rue de la convention
        • Contact:
        • Principal Investigator:
          • Maeva GELU, Physical therapist
      • Nantes, France, 44100
        • cabinet de kinésithérapie, NANTES 44100 2-4 route de Paris
        • Contact:
        • Principal Investigator:
          • Emeline LEBOEUF, Physical therapist
      • Orléans, France, 45100
        • Cabinet de kinésithérapie, 45100 Orléans 44 avenue de la Mouillère
        • Contact:
        • Principal Investigator:
          • Nolwenn POCQUET, Physical therapist
      • Paris, France, 75019
        • Cabinet de kinésithérapie, PARIS 75019 2, rue de Sadi Lecointe
        • Contact:
        • Principal Investigator:
          • Kader NDIAYE, Physical therapist
      • Rezé, France, 44400
        • Cabinet de kinésithérapie, 44400 REZE 15 avenue Louise Michel
        • Contact:
        • Principal Investigator:
          • Damien HRYNKOW, Physical therapist
      • Saint-Herblain, France, 44800
        • cabinet de kinésithérapie, 44800 St Herblain Boulevard charles gautier
        • Contact:
        • Principal Investigator:
          • Léa GUILBEAU, Physical therapist
      • Saint-Yorre, France, 03270
        • cabinet de kinésithérapie, 03270 SAINTYORRE 10, rue de la République
        • Contact:
        • Principal Investigator:
          • Philippe DEAT, Physical therapist
      • Serres-Castet, France, 64121
        • Cabinet de kinésithérapie, 64121 Serres Castet 7 bis chemin de Liben
        • Contact:
        • Principal Investigator:
          • Florent JACQUEMIN, Physical therapist
      • Éragny, France, 95610
        • Cabinet de kinésithérapie, ERAGNY 95610 5 allée Rosa Luxemburg
        • Contact:
        • Principal Investigator:
          • Audrey VIERS, Physical therapist

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

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Over 18 years
  • Upper limb unilateral CRPS (Budapest criteria)
  • No prior use of GMI

Exclusion Criteria:

  • Psychiatric disorders
  • Not confident with written/spoken French
  • Not confident with smartphone use

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: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Group "Graded Motor Imagery + Therapeutic exercises"
Graded Motor Imagery (left/right discrimination, explicit motor imagery, mirror therapy) and exercises (15 minutes, 3 times per day, 6 weeks)
Other: Graded Motor Imagery + Therapeutic exercises

Functional, mobility, strengthening, and mobilization exercises, both passive and active.

The exercises are designed to improve mobility and function in the affected limb.

In addition to this standard treatment, the intervention group will receive care using Gradual Motor Imagery.

The protocol lasts 6 weeks (3 sessions of 15 minutes per day), divided into 3 phases: implicit motor imagery, explicit motor imagery followed by mirror therapy
Sham Comparator: Group "Sham-GMI (non-motor mental imagery) + Therapeutic exercises"
Sham-GMI (non-motor mental imagery) + Therapeutic exercises
Other: Sham-GMI (non-motor mental imagery) + Therapeutic exercises

Functional, mobility, strengthening, and mobilization exercises, both passive and active.

The exercises are designed to improve mobility and function in the affected limb.

In addition to this standard treatment, the control group will receive a non-motor mental imagery intervention (visual imagery or sham-GMI), designed not to stimulate the sensorimotor areas of the brain while resembling IMG (3 sessions of 15 minutes per day for 6 weeks).

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Body perception disorders (Bath Scale)
Time Frame: End of intervention (Week 6)
Assessment of body perception disturbances; 7 items
End of intervention (Week 6)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Body perception disorders (Bath Scale)
Time Frame: 3 months after intervention (M3)
Assessment of body perception disturbances; 7 items
3 months after intervention (M3)
Mean pain intensity (Numeric rating scale)
Time Frame: End of intervention (Week 6), 3 months after intervention (M3)
Mean pain during the last week, mean pain during the last week during movement, mean pain during the last week at rest
End of intervention (Week 6), 3 months after intervention (M3)
QuickDash
Time Frame: End of intervention (Week 6), 3 months after intervention (M3)
Self-reported assessment of upper limb function :
End of intervention (Week 6), 3 months after intervention (M3)
PROMIS 29
Time Frame: End of intervention (Week 6), 3 months after intervention (M3)
Self-reported assessment of quality of life (7 domains, 29 items)
End of intervention (Week 6), 3 months after intervention (M3)
Pain Catastrophizing Scale (PCS)
Time Frame: End of intervention (Week 6), 3 months after intervention (M3)
Self-reported assessment of pain catastrophizing
End of intervention (Week 6), 3 months after intervention (M3)
Tampa Scale of Kinesiophobia (short form)
Time Frame: End of intervention (Week 6), 3 months after intervention (M3)
Self-reported assessment of fear of movement (6 items)
End of intervention (Week 6), 3 months after intervention (M3)
Pain Self Efficacy Questionnaire (PSEQ)
Time Frame: End of intervention (Week 6), 3 months after intervention (M3)
Self-reported assessment of confidence in performing activities despite ongoing pain
End of intervention (Week 6), 3 months after intervention (M3)
Patient Global Impression of Change (PGIC)
Time Frame: End of intervention (Week 6), 3 months after intervention (M3)
Self-administered questions asking respondents to rate how their condition has changed since the intervention
End of intervention (Week 6), 3 months after intervention (M3)
Medication Quantification Scale (MQS)
Time Frame: End of intervention (Week 6), 3 months after intervention (M3)
MQS quantifies pain medication use and provides a score.
End of intervention (Week 6), 3 months after intervention (M3)

Collaborators and Investigators

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

Sponsor

Nantes University Hospital

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 (Estimated)

October 1, 2026

Primary Completion (Estimated)

May 15, 2028

Study Completion (Estimated)

July 1, 2028

Study Registration Dates

First Submitted

September 8, 2026

First Submitted That Met QC Criteria

September 8, 2026

First Posted (Actual)

September 14, 2026

Study Record Updates

Last Update Posted (Actual)

September 14, 2026

Last Update Submitted That Met QC Criteria

September 8, 2026

Last Verified

September 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • RC25_0515

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

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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