# Motor Imagery and Action Observation in Breast Cancer Survivors: Protocol for a Randomized Controlled Trial

## TL;DR

This study tests if combining motor imagery and action observation therapies can help breast cancer survivors reduce pain and improve mobility and strength.

## Contribution

The paper introduces a novel combination of motor imagery and action observation therapies for breast cancer survivors.

## Key findings

- The study will evaluate pain intensity, muscle strength, and joint range in participants.
- It is expected to show improvements in lymphedema symptoms and fear of movement.
- Results will be published in 2026 after data analysis.

## Abstract

Breast cancer is the most common type of cancer in women worldwide, and its incidence is increasing. Although breast cancer survival is slowly increasing, related sequelae can persist after the disease has been treated. The main physical symptoms associated with breast cancer survival include pain, lymphedema, and associated functional limitations. Although multiple treatments are available for alleviating symptoms in breast cancer survivors, their effectiveness remains limited. Motor imagery (MI) and action observation (AO) therapies, which are based on the theory of motor simulation and are used in multiple fields with satisfactory results, have been proposed as alternatives for treating pain and improving mobility and strength.

This study aims to design, implement, and evaluate the effectiveness of a program combining MI and AO therapies to improve functionality and mobility and alleviate pain and lymphedema of the affected upper limb in women who have survived breast cancer.

A randomized controlled clinical study will be conducted in a sample of 108 participants who have experienced breast cancer and, as a result, have pain in the affected extremity, lymphedema, or loss of strength and/or mobility. The intervention group will include 54 participants managed with the MI and AO program (a combination of MI, AO, and mobility exercises), while the control group will consist of 54 women performing mobility exercises alone. Pain intensity, muscle strength, joint range, limb diameter, fear of movement, and imagery capability will be evaluated.

The intervention is expected to yield improvements in pain intensity, joint range, muscle strength, and symptoms associated with lymphedema, among other outcomes. The study was funded in December 2023. The number of participants recruited as of manuscript submission is approximately 80, and data analysis has not yet started. These results will be published in 2026.

The implementation of an intervention based on MI and AO has the potential to positively impact female breast cancer survivors who face physical and psychological sequelae that interfere with their daily lives.