Effects of graded motor imagery on fear of movement, pain, and rehabilitation in patients with kinesiophobia after video‐assisted thoracoscopic surgery for lung cancer: A randomized controlled trial

Abstract Objective This study aimed to evaluate the effects of graded motor imagery (GMI) on fear of movement, pain, and rehabilitation in patients with kinesiophobia after video‐assisted thoracoscopic surgery (VATS) for lung cancer. Methods Fifty‐eight participants with kinesiophobia after VATS were randomly assigned into two groups: one receiving usual care (the control group) and the other receiving usual care plus GMI (the GMI group). The GMI was delivered in three stages: left/right limb identification, motor imagery, and mirror therapy delivered by two researchers every afternoon starting on the first postoperative day, once a day for about 40 min, at least twice. Level of fear of movement, pain‐related patient‐reported outcomes (PROs), rehabilitation exercise participation, and peak expiratory flow (PEF) were compared between the two groups. Results Twenty‐seven eligible participants were included in the GMI group and 29 in the control group. Compared to the reports on the first postoperative day, the participants who received GMI reported at discharge significant reductions in kinesiophobia, intensity of worst pain and least pain, and interference of pain with activities and emotions, and increases in rehabilitation exercise participation and PEF than those in the control group ( p < 0.05). An unexpected finding was a reduced surgery‐to‐discharge interval in the patients who received GMI (almost a day earlier than those in the control group). Conclusion GMI can reduce fear of movement, improve pain‐related PROs, and increase rehabilitation exercise participation and PEF for lung cancer patients with kinesiophobia after VATS. The study was registered at the Chinese Clinical Trial Registry (ChiCTR2300072612).