Impact of a digital mindfulness and motor imagery intervention on pain and perceived function in 203 patients with musculoskeletal pain

Background: Musculoskeletal pain (MSP) is associated with persistent pain, functional impairment, and altered neuromuscular control mechanisms. Mindfulness and motor imagery interventions may target central sensorimotor dysfunctions involved in pain persistence. This study evaluated the effects of a digital intervention combining mindfulness and guided motor imagery on pain and perceived function in patients with MSP.

Methods: This observational study analyzed 203 consecutive users with complete datasets who used a standardized digital intervention delivered through the Yuzit® application. The program combined mindfulness exercises and guided motor imagery sessions adapted to the painful anatomical area, covering eight musculoskeletal regions. Outcomes were assessed at baseline (T0), before the third session (T1), and after program completion (T2). Pain intensity was measured using the 11 points Numerical Rating Scale (NRS; 0–10) and perceived function using the Single Assessment Numeric Evaluation (SANE). The Minimal Clinically Important Difference (MCID) was defined as a VAS reduction ≥ 2 points. Secondary analyses evaluated the influence of age, sex, symptom duration, pain location, and baseline pain severity.

Results: The cohort included 122 women (60.1%) and 81 men (39.9%) with a mean age of 46.4 ± 16.6 years. Mean NRS improved from 5.17 ± 2.00 at T0 to 3.26 ± 2.40 at T2 ( Δ = −1.91; t = −12.45; p < 0.000001), while mean SANE improved from 54.7 to 65.3 ( Δ = + 10.5 points; +19.2%). The MCID was achieved by 50.2% of patients, and 74.4% showed any improvement. Improvement was observed across all anatomical locations and symptom durations. In patients with chronic symptoms lasting more than one year ( n = 117; 57.6%), 74.4% of patients improved and 51.3% achieved the MCID (t = −9.56; p < 0.001), with no significant difference across chronicity groups (one-way ANOVA: F = 0.485; p = 0.616). Patients with higher baseline pain showed greater improvements (NRS ≥ 6: Δ NRS = −2.53; Δ SANE = + 14.1). Satisfaction was high, with 64.0% of patients reporting satisfaction scores ≥ 4/5.

Conclusions: A standardized digital intervention combining mindfulness and guided motor imagery was associated with rapid and clinically relevant improvements in pain and perceived function across all musculoskeletal regions and patient profiles, including chronic pain populations. Randomized controlled studies with objective outcomes are required to confirm these findings and investigate potential mechanisms.