Neuromuscular Reactivation Through Guided Visualization Combining Mindfulness and Motor Imagery via the Yuzit App: Protocol for a Randomized Controlled Trial

Background: Neuromuscular activation disorders are frequently observed in patients with musculoskeletal pain and may contribute to persistent symptoms and delayed functional recovery. Neurocognitive approaches combining mindfulness and motor imagery have been proposed to target central mechanisms involved in motor control and pain modulation. Digital health tools offer an opportunity to standardize and disseminate such interventions in real-world settings. Objective: The aim of this study is to describe a neuromuscular reactivation method combining mindfulness and guided motor imagery and its digital implementation via the Yuzit app and to report preliminary observational data from real-world use. Methods: This paper primarily presents a detailed description of the intervention and its digital delivery. The protocol consists of a brief mindfulness phase followed by guided motor imagery exercises targeting specific muscle groups. In addition, we report exploratory observational data derived from the first 30 consecutive users who completed the program in routine conditions. Data were retrospectively collected through the app, including visual analogue scale (VAS) and single assessment numeric evaluation (SANE) scores, as well as user satisfaction. Analyses were descriptive and exploratory. Results: Among the first 30 users (mean age 50, SD 15.4 y; female: n=19, 63%), preliminary observations showed a reduction in VAS scores (from 5.62, SD 1.97 to 4.00, SD 2.15) and an increase in SANE scores (from 51.8, SD 17.2 to 65.1, SD 18.9) after completion of the program. Overall satisfaction was high or very high in 83% (n=25) of users. These findings are descriptive and should be interpreted as exploratory only. Conclusions: This study describes a standardized digital intervention combining mindfulness and motor imagery for neuromuscular reactivation. Preliminary real-world observations suggest the feasibility of the approach and its potential to generate patient-reported outcome data. However, no conclusions regarding efficacy can be drawn. Further controlled studies are required to evaluate clinical effectiveness.