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Primary DysmenorrheaNCT07196150

Exercise, Motor Imagery, and Pain Neuroscience Education for Primary Dysmenorrhea

A study testing Exercise Program, Exercise plus Motor Imagery Training and Exercise plus Pain Neuroscience Education in people with Primary Dysmenorrhea, run by Muge Dereli at 1 site in Turkey (Türkiye).

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The goal of this clinical trial is to find out whether exercise, motor imagery training, and pain neuroscience education can help reduce menstrual pain and improve well-being in young women with primary dysmenorrhea. Read more about this study

Who is it for?
Ages 18 to 25 years, women only
Conditions the study is for
Primary Dysmenorrhea
What is being tested?
Exercise Program, Exercise plus Motor Imagery Training and Exercise plus Pain Neuroscience Education
Could I receive a placebo?
No, everyone receives an active treatment
How many people
67 participants
Where
1 siteTurkey (Türkiye)
Study dates
25 Feb 2025to 5 Jun 2026
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 25 years
  • Women only
  • No healthy volunteers
  • Adult

Who may be able to join

  • Female, aged 18-25 years
  • Gynecological examination and ultrasound confirming absence of pelvic pathology
  • History of primary dysmenorrhea for at least 6 months, with pain intensity ≥4 on the Numeric Rating Scale (0-10) during the first 3 days of menstruation
  • Regular menstrual cycles (21-35 days)
  • Nulliparous (no history of pregnancy or childbirth)
  • No systemic, metabolic, rheumatologic, or lumbar pathology
  • Willingness to participate in the 8-week intervention program and attend follow-up assessments

Who cannot join

  • Diagnosis of secondary dysmenorrhea (e.g., endometriosis, pelvic inflammatory disease, uterine fibroids, ovarian cysts)
  • Current pregnancy or planning to become pregnant during the study period
  • History of pelvic or abdominal surgery
  • History of sexually transmitted diseases
  • Current use of antidepressants, anxiolytics, or hormonal therapy (e.g., oral contraceptives, intrauterine device)
  • Known neurological, psychiatric, or systemic musculoskeletal disorders
Show all 9Show fewer
  • Cognitive impairment or attention deficit that may interfere with participation
  • Participation in regular exercise in the last 6 months
  • Use of alternative therapies for dysmenorrhea (e.g., acupuncture, massage)

Trial locations and contacts

1 site in 1 country.

Turkey (Türkiye)1 site
  • Aydın Adnan Menderes University

    Aydin, Efeler

Other trials in Turkey (Türkiye)

About this study

Official title: Comparison of the Effects of Exercise, Motor Imagery Training, and Pain Neuroscience Education on Pain, Menstrual Symptoms, and Cognitive Flexibility in Women With Primary Dysmenorrhea: A Randomized Controlled Trial

The goal of this clinical trial is to find out whether exercise, motor imagery training, and pain neuroscience education can help reduce menstrual pain and improve well-being in young women with primary dysmenorrhea. The study will also look at how these approaches affect menstrual symptoms, movement control, and cognitive flexibility.

The main questions it aims to answer are:

Read more
  • Does adding motor imagery or pain neuroscience education to an exercise program reduce pain and menstrual symptoms more than exercise alone?
  • Do these approaches improve movement control, thinking flexibility, and knowledge about pain?

Researchers will compare three groups:

  • Exercise only
  • Exercise plus motor imagery training
  • Exercise plus pain neuroscience education

Participants will:

  • Attend supervised exercise sessions twice a week for 8 weeks
  • Practice either motor imagery or receive short pain neuroscience education, depending on their group
  • Complete questionnaires and tests before and after the program, during the first three days of menstruation
Read the detailed description

Primary dysmenorrhea is a common gynecological condition characterized by menstrual pain without underlying pathology. It negatively impacts quality of life and may affect cognitive functions such as attention and flexibility. Non-pharmacological interventions such as exercise, motor imagery, and pain neuroscience education are promising approaches for pain management without side effects. However, evidence on their effectiveness in primary dysmenorrhea is limited.

This randomized controlled trial is designed to compare the effects of three different interventions in young women with primary dysmenorrhea:

  • Exercise only (control group)
  • Exercise plus Motor Imagery Training
  • Exercise plus Pain Neuroscience Education (PNE)

Eligible participants will be women aged 18-25 years who meet the diagnostic criteria for primary dysmenorrhea based on gynecological examination and ultrasound findings. Participants will be randomly assigned into one of the three groups. All groups will undergo an 8-week supervised exercise program (two sessions per week) focusing on lumbopelvic stabilization, flexibility, and endurance training. In addition:

  • The Motor Imagery group will practice kinesthetic visualization of the exercises prior to performing them.
  • The PNE group will receive weekly face-to-face education sessions on pain mechanisms, supported with home assignments.

Primary outcome measures are:

  • Pain intensity (Numeric Pain Rating Scale)
  • Pressure pain threshold (Baseline dolorimeter)
  • Menstrual symptoms (Menstrual Symptom Questionnaire).

Secondary outcome measures are:

  • Lumbopelvic motor control (Physiosupplies Core Stabilizer Unit)
  • Movement Imagery Questionnaire
  • Central Sensitization Inventory
  • Cognitive flexibility (Stroop Test)
  • Pain Catastrophizing Scale
  • Pain Resilience Scale
  • Modified Pain Neurophysiology Questionnaire.

Assessments will be conducted at baseline and after the 8-week intervention, within the first three days of menstruation. Additional follow-up data will be collected through online forms one month after the intervention to evaluate persistence of effects.

The estimated sample size of 51 was calculated considering a 10% attrition rate. Statistical analyses will be performed using SPSS software. Depending on data distribution, repeated measures ANOVA or non-parametric equivalents will be used to compare changes over time and between groups.

This study is expected to provide new evidence regarding the effectiveness of combining exercise with motor imagery or pain neuroscience education for the management of pain, menstrual symptoms, and cognitive flexibility in women with primary dysmenorrhea. The findings may contribute to the development of safe and effective non-pharmacological strategies in women's health and pain management.

Being tested
Exercise Program, Exercise plus Motor Imagery Training, Exercise plus Pain Neuroscience Education
Keywords
Primary dysmenorrhea, Menstrual pain, Exercise, Motor imagery, Pain education, Cognition
Medical subject headings
Dysmenorrhea, Motor Activity

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Exercise ProgramBehavioural

    Participants will complete an 8-week supervised exercise program, delivered twice per week. The program includes lumbopelvic stabilization, stretching, and endurance training exercises designed to reduce menstrual pain and improve physical function.

  • Exercise plus Motor Imagery TrainingBehavioural

    Participants will complete the same 8-week supervised exercise program as the Exercise Only group. In addition, they will practice kinesthetic motor imagery of the prescribed movements prior to performing them, aiming to enhance motor control and pain modulation.

  • Exercise plus Pain Neuroscience EducationBehavioural

    Participants will complete the same 8-week supervised exercise program as the Exercise Only group. In addition, they will receive weekly face-to-face pain neuroscience education sessions focused on pain neurophysiology, supported with home assignments to reinforce learning.

Study groups in NCT07196150
Study groupRoleWhat they receive
Exercise OnlyExperimentalParticipants will complete an 8-week supervised exercise program including lumbopelvic stabilization, stretching, and endurance training, delivered twice per week.
Receives: Behavioral: Exercise Program
Exercise + Motor ImageryExperimentalParticipants will complete the same 8-week supervised exercise program. In addition, they will practice kinesthetic motor imagery of the exercises before performing them.
Receives: Behavioral: Exercise Program; Behavioral: Exercise plus Motor Imagery Training
Exercise + Pain Neuroscience EducationExperimentalParticipants will complete the same 8-week supervised exercise program. In addition, they will receive weekly face-to-face pain neuroscience education sessions supported by home assignments.
Receives: Behavioral: Exercise Program; Behavioral: Exercise plus Pain Neuroscience Education

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Pain Intensity

    Pain intensity will be assessed using an 11-point Numeric Rating Scale (0 = no pain, 10 = worst imaginable pain). Participants will be asked to report their average menstrual pain during the first three days of menstruation.

    Measured: Baseline, after 8 weeks of intervention, and 1 month post-intervention follow-up

  2. Pressure Pain Threshold (PPT)

    Pressure pain threshold will be measured using a digital algometer (Baseline dolorimeter) applied to the abdominal region and standardized body sites. The minimum pressure (kg/cm²) at which pain is first perceived will be recorded.

    Measured: Baseline and after 8 weeks of intervention (first three days of menstruation)

  3. Menstrual Symptom Severity

    Menstrual symptoms (e.g., cramps, headache, back pain, fatigue, mood changes) will be evaluated using the Menstrual Symptom Questionnaire (MSQ). Total and subscale scores will be calculated.

    Measured: Baseline, after 8 weeks of intervention, and 1 month post-intervention follow-up

Secondary outcomes (7)
  1. Lumbopelvic Motor Control

    Lumbopelvic motor control will be assessed using the Physioupplies Core Stabilizer Unit, which measures pressure changes during standardized stabilization tasks.

    Measured: Baseline and after 8 weeks of intervention

  2. Movement Imagery Ability

    Participants' ability to generate and control movement imagery will be assessed using the Movement Imagery Questionnaire. Higher scores indicate better imagery ability.

    Measured: Baseline

  3. Central Sensitization

    Central sensitization symptoms will be evaluated using the Central Sensitization Inventory (CSI). The total score reflects symptom severity.

    Measured: Baseline, after 8 weeks of intervention, and 1 month post-intervention follow-up

  4. Cognitive Flexibility

    Cognitive flexibility and inhibitory control will be assessed using the EncephalApp Stroop application. Participants will complete the "off" and "on" runs. Primary variables will be total completion time (seconds) and error count; lower times and fewer errors indicate better performance.

    Measured: Baseline and after 8 weeks of intervention

  5. Pain Catastrophizing

    Catastrophic thinking related to pain will be assessed with the Pain Catastrophizing Scale, which includes rumination, magnification, and helplessness subscales.

    Measured: Baseline, after 8 weeks of intervention, and 1 month post-intervention follow-up

  6. Pain Resilience

    Resilience in response to pain will be measured using the Pain Resilience Scale. Higher scores indicate better psychological resilience.

    Measured: Baseline, after 8 weeks of intervention, and 1 month post-intervention follow-up

  7. Pain Neurophysiology Knowledge

    Participants' knowledge of pain mechanisms will be evaluated using the Revised Neurophysiology of Pain Questionnaire (NPQ). Higher scores indicate greater understanding of pain biology. The questionnaire will be administered to all participants at baseline (before the start of the intervention). In addition, it will be repeated only in the Pain Neuroscience Education (PNE) group immediately after the 8-week intervention and 1 month later to evaluate changes in knowledge.

    Measured: Baseline (all groups); post-intervention and 1-month follow-up (PNE group only)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted29 Sep 2025
  2. Study start25 Feb 2025
  3. Primary completion5 Jun 2026
  4. Study completion5 Jun 2026

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
67 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07196150
Sponsor's protocol ID
IKCU-IRB-0260
Other IDs
IRB# 0260
Status last verified
Jul 2026
First submitted
19 Sep 2025
Last updated
28 Jul 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: De-identified individual participant data (pain intensity scores, pressure pain threshold values, questionnaire results, and demographic data) will be shared

Publications

  • Louw A, Zimney K, Puentedura EJ, Diener I. The efficacy of pain neuroscience education on musculoskeletal pain: A systematic review of the literature. Physiother Theory Pract. 2016 Jul;32(5):332-55. doi: 10.1080/09593985.2016.1194646. Epub 2016 Jun 28.

    PubMed 27351541
  • Evans S, Dowding C, Olive L, Payne LA, Druitt M, Seidman LC, Skvarc D, Mikocka-Walus A. Pain catastrophizing, but not mental health or social support, is associated with menstrual pain severity in women with dysmenorrhea: A cross-sectional survey. Psychol Health Med. 2022 Jul;27(6):1410-1420. doi: 10.1080/13548506.2021.1948581. Epub 2021 Jun 30.

    PubMed 34190659
  • Cuenca-Martinez F, Nieves-Gomez A, Millan-Isasi N, Fuentes-Aparicio L, Sempere-Rubio N. Effects of motor imagery and action observation on pelvic floor and related structures in healthy women: A randomized controlled trial. Hum Mov Sci. 2025 Feb;99:103313. doi: 10.1016/j.humov.2024.103313. Epub 2024 Dec 2.

    PubMed 39626586
  • Kluska J, Malinowska E, Kowalski J. A pilot longitudinal study of decrease in cognitive functions during the most painful day of the period among women with primary dysmenorrhea. Arch Gynecol Obstet. 2025 Feb;311(2):341-346. doi: 10.1007/s00404-024-07617-9. Epub 2024 Jul 4.

    PubMed 38963585
  • Carroquino-Garcia P, Jimenez-Rejano JJ, Medrano-Sanchez E, de la Casa-Almeida M, Diaz-Mohedo E, Suarez-Serrano C. Therapeutic Exercise in the Treatment of Primary Dysmenorrhea: A Systematic Review and Meta-Analysis. Phys Ther. 2019 Oct 28;99(10):1371-1380. doi: 10.1093/ptj/pzz101.

    PubMed 31665789

Questions about this trial

What is this clinical trial studying?

A study testing Exercise Program, Exercise plus Motor Imagery Training and Exercise plus Pain Neuroscience Education in people with Primary Dysmenorrhea, run by Muge Dereli at 1 site in Turkey (Türkiye).

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 28 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Pain Intensity (time frame: Baseline, after 8 weeks of intervention, and 1 month post-intervention follow-up). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07196150, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Jul 2026.

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