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Effectiveness of Mindfulness-Based Cognitive Therapy and Graded Motor Imagery on Kinesiophobia in Individuals with Median Nerve Injury: A Randomized Controlled Trial

Priyanka Bai, Kezia Jenny V.M., Mohamed Sahal, Prathap Suganthirababu

Physical rehabilitation and recreational health technologies October 30, 2026 DOI: 10.15391/prrht.2026-11(5).01 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Randomized controlled trial Peer reviewed
Sample size 30
Population Individuals with median nerve injury
Interventions Mindfulness-Based Cognitive Therapy (MBCT) Graded Motor Imagery (GMI) conventional physiotherapy
Duration 6 weeks, 3 sessions per week, 90 minutes per session
Measures Tampa Scale for Kinesiophobia-11 (TSK-11), Quick Disabilities of Arm, Shoulder and Hand (QuickDASH)
Topics Meditation
Key findings Both MBCT and GMI combined with conventional physiotherapy reduced kinesiophobia and improved upper limb function, but GMI led to greater improvements, with significant time-by-group interactions for TSK-11 (partial η²=0.394) and QuickDASH (partial η²=0.533).

Abstract

Purpose. Median nerve injury is often associated with pain and functional impairment, which can contribute to kinesiophobia and limit upper limb recovery. Such psychological factors causing fear of movement can substantially delay recovery. This study aimed to compare the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) and Graded Motor Imagery (GMI) on kinesiophobia in individuals with median nerve injury. Materials & Methods. This comparative study was carried out in a private clinical rehabilitation setting. Thirty participants with median nerve injury were randomly allocated to either MBCT plus conventional physiotherapy or GMI plus conventional physiotherapy. Both interventions were administered three times per week for 6 weeks, with each session lasting 90 minutes. The MBCT intervention comprised mindfulness-based cognitive sessions, while the GMI intervention comprised laterality training, motor imagery and mirror therapy. The pre-and-post interventional outcomes were assessed using the Tampa Scale for Kinesiophobia-11 (TSK-11) and Quick Disabilities of Arm, Shoulder and Hand (QuickDASH). Results. At post-intervention, both groups demonstrated statistically and clinically meaningful improvements in kinesiophobia and upper limb function (p<0.001). Repeated-measures ANOVA revealed significant time × group interaction effects for TSK-11 (F=18.193, p<0.001, partial η²=0.394) and QuickDASH (F=31.943, p<0.001, partial η²=0.533), indicating greater improvements in the Graded Motor Imagery group compared to the Mindfulness-Based Cognitive Therapy group. Conclusions. Both Mindfulness-Based Cognitive Therapy and Graded Motor Imagery combined with conventional physiotherapy were effective in reducing kinesiophobia and improving functional outcomes. However, Graded Motor Imagery demonstrated greater improvements.

Comparable studies

Other randomized controlled trials on meditation, most cited first.

Study Year Design Participants
Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment 2003 Randomized controlled trial n = 41
Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients 2000 Randomized controlled trial n = 145
Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults 2008 Randomized controlled trial n = 139
Short-term meditation training improves attention and self-regulation Undergraduate Chinese students 2007 Randomized controlled trial n = 40
Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients 2004 Randomized controlled trial n = 73

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