Effect of Graded Motor Imagery on Pressure Pain Threshold and Pain Intensity in Women With Primary Dysmenorrhea: A Randomized Controlled Trial
The goal of this clinical trial is to learn if graded motor imagery can reduce pain sensitivity and period pain in women with primary dysmenorrhea (painful periods with no medical cause). The main questions it aims to answer are: 1. Is there a decrease in pressure pain threshold (increased pain sensitivity) with graded motor imagery? 2. Is the intensity of menstrual pain reduced by graded motor imagery? 3. Is GMI helpful to reduce menstrual symptoms and pain catastrophizing (negative thinking about pain)? Researchers will compare full GMI (active intervention), a sham GMI(inactive intervention), and a wait-list (no intervention) to see if GMI works better than the alternatives. Participants will: 1. Take part in a 6-week graded motor imagery program, sham program, or no intervention control. 2. Do laterality recognition, motor imagery, and mirror therapy exercises in the graded motor imagery group. 3. Complete pain and symptom assessments before and after the program, and again at follow-up.
• Female sex (aged 18-30 years)
• Diagnosis of primary dysmenorrhea confirmed by a physician (painful menstruation for ≥6 consecutive cycles, in the absence of identifiable pelvic pathology on clinical and/or ultrasound evaluation)
• Pain ≥4/10 NRS experienced during the last period.
• Confirmed altered pressure pain threshold: PPT ≥2 standard deviations below published norms for age-matched healthy women, measured at baseline assessment
• Regular menstrual cycle (21-35 days)
• Capable of engaging in virtual video sessions and taking online tests.
• Consent to withhold new analgesic or hormonal treatments during the study period.