Motor imagery enhances early rehabilitation in patients with high kinesiophobia after total knee arthroplasty: a randomized controlled trial.

Abstract

To investigate the effects of motor imagery on psychological and physical outcomes during acute-phase rehabilitation following total knee arthroplasty. A single-blind, randomized controlled trial. Forty patients who underwent total knee arthroplasty and scored ≥37 on the Tampa Scale of Kinesiophobia were enrolled and randomly allocated to either a motor imagery group or a control group. Both groups received the same 2-week standard rehabilitation programme beginning within 48 h post-surgery. The motor imagery group additionally performed structured motor imagery sessions prior to exercise. Outcomes included kinesiophobia, pain catastrophizing, self-efficacy, exercise adherence, pain intensity, knee range of motion, and quadriceps strength. Assessments were performed by blinded evaluators before and after the intervention. Both groups showed significant improvements in all outcome measures (p < 0.05), with the motor imagery group achieving significantly greater gains in psychological variables, pain reduction, and physical function compared with the control group (p < 0.05). Motor imagery is an effective adjunct to early rehabilitation after total knee arthroplasty. Its use enhances psychological resilience, supports adherence, and accelerates functional recovery, indicating its value in comprehensive, multidimensional rehabilitation strategies.