Central Neuromuscular Reactivation Using Digital Mindfulness and Motor Imagery Intervention for Chronic Knee Pain in Patients With Obesity: Prospective, Single-Center Study

Background: Chronic musculoskeletal pain, particularly in patients with obesity, poses significant challenges due to increased pain sensitivity, reduced mobility, and systemic inflammation. Obesity aggravates mechanical constraints on the joints and increases systemic inflammation, exacerbating certain medical conditions and making conventional therapeutic approaches less likely to succeed. Conventional therapies often show limited efficacy, necessitating innovative approaches. Objective: This pilot study evaluated the short-term effectiveness of a mindfulness and motor imagery-based intervention delivered via an app (SAS YUZIT), on the pain, functionality, and quality of life of patients with obesity and chronic knee pain. Methods: A prospective, single-center study was conducted over 1 month by including 30 patients (BMI >30 kg/m2) experiencing chronic knee pain (≥3 months) who did not need surgery. Patients underwent two video-guided motor imagery sessions, focusing on neuromuscular reactivation. Functional scores, including the Single Assessment Numeric Evaluation (SANE) score, Knee Injury and Osteoarthritis Outcome Score (KOOS), and 36-Item Short Form Health Survey (SF-36) score, were assessed before and after intervention. Paired t tests were used to analyze score improvements, with P