Effects of Motor Imagery Intervention on Functional Recovery Following Total Knee Arthroplasty

NCT03684148 | Completed DMC

• 1 other identifier: Knee Study Valdoltra 2017
• Study Type: interventional
• Target: 34
• Locations: 1 country
• Sites: 1

Brief Summary

The knee osteoarthritis becoming a leading cause of disability among older adults' population. When conventional treatments fail, a total knee arthroplasty (TKA) is suggested. Although TKA treatment significantly reduces pain and improve mobility of patients, there is still high prevalence of patients whose neuromuscular function is impaired up to three years following TKA, which can be directly prescribed to poor or/and inadequate rehabilitation practice. Thus, motor imagery (MI) is proposed as additional rehabilitation tool to convention physical therapy to reduce decline of neuromuscular function in early days post-surgery. Recent studies showed that MI could facilitate learning and acquisition of motor skills, as well as maintain and retain previously acquired motor skills, which may be beneficial for those who undergo TKA. It represents an incentive in the process of motor learning and the transfer of the mental scheme of the motion pattern into the process of movement execution. Measuring neuromuscular function pre- and post-TKA could be unique opportunity to provide empirical evidence about its additional therapeutic effects. Outcomes of proposed research project could serve to improve existing intervention programs applied in rehabilitation protocols following TKA surgery as well as other orthopedic interventions. This would also contribute to the successful return of individuals after an injury to their everyday working routine. We hypothesized that MI practice group will experience better both subjective and objective measures of functional performance compared to control group that will be subjected to routine physical therapy only.

Conditions

Osteo Arthritis Knee; Knee Arthroplasty

Keywords

osteoarthritis; muscle voluntary activation; knee replacement; cognitive training; functional performance; randomized controlled trial

Outcome Measures

Primary Outcomes (1)

• Change in maximal voluntary isometric contraction of quadriceps muscle following a total knee arthroplasty

  Maximal strength assessed by isometric dynamometer

  At baseline (1 day before surgery) and one month postoperatively

Secondary Outcomes (11)

• Change in quadriceps muscle voluntary activation following a total knee arthroplasty

  At baseline (1 day before surgery) and one month postoperatively

• Change in range of motion of knee joint following a total knee arthroplasty

  At baseline (1 day before surgery) and one month postoperatively

• Change in agility following a total knee arthroplasty

  At baseline (1 day before surgery) and one month and one year postoperatively

• Change in repetitive strength of knee extensor muscles following a total knee arthroplasty

  At baseline (1 day before surgery) and one month postoperatively and one year postoperatively

• Change in spatio temporal gait parameters following a total knee arthroplasty

  At baseline (1 day before surgery) and one month postoperatively

Study Arms (2)

Motor imagery practice

EXPERIMENTAL

In addition to routine physical therapy patients that will be included in the motor imagery practice (MIp) group will receive an additional intervention based on motor imagery beginning immediately after the TKA procedure.

Other: Motor imagery practice

Control group

NO INTERVENTION

Patients from the control group will underwent the same post-surgery rehabilitation program, but will not be engaged in MI practice.

Interventions

Motor imagery practice OTHER

In detail, they were advised to imagine maximal voluntary isometric contractions (MViC). MViC imagery practice was planned in a progressive manner. Thus, it was performed in two sets of 25 repetitions with 2 minutes of inter-sets rest period, for two weeks, and 10 additional repetitions were added on week three and four, respectively. Each MViC repetition was sustained for 5 seconds, followed by 5 seconds of inter-repetition rest periods. Additionally, after every fifth contraction, participants had a 20 seconds of rest. Following 5 days of MI practice, the participants were advised to take a break from MI for two consecutive days. After hospital discharge, the participants in the MIp group were supplied with an audio description of the exercises to be performed.

Also known as: Routine physical therapy

Motor imagery practice

Eligibility Criteria

• Age: 50 Years - 80 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• patients scheduled for unilateral TKA secondary to osteoarthritis;
• age from 50 to 80 years old;
• participants were not engaged in preoperative treatments

You may not qualify if:

• participants who were undergoing a revision TKA;
• body mass index (BMI) greater than 40 kg/m2;
• participants who were receiving a bilateral TKA's;
• uncontrolled hypertension;
• diabetes mellitus;
• a history of any neurological disorder;
• multiple sclerosis;
• Parkinson's disease;
• patients with rheumatoid arthritis or active cancer;
• previous history of deep vein thrombosis;
• contralateral knee OA (as defined by pain greater than 4/10 with activity)

Sponsors & Collaborators

• Science and Research Centre Koper: lead
• Slovenian Research Agency: collaborator

Study Sites (1)

Orthopaedic Hospital Valdoltra

Ankaran, 6280, Slovenia

Location

Related Publications (2)

• Paravlic AH, Pisot R, Marusic U. Specific and general adaptations following motor imagery practice focused on muscle strength in total knee arthroplasty rehabilitation: A randomized controlled trial. PLoS One. 2019 Aug 14;14(8):e0221089. doi: 10.1371/journal.pone.0221089. eCollection 2019.

  PMID: 31412056 RESULT

• Paravlic AH, Maffulli N, Kovac S, Pisot R. Home-based motor imagery intervention improves functional performance following total knee arthroplasty in the short term: a randomized controlled trial. J Orthop Surg Res. 2020 Oct 2;15(1):451. doi: 10.1186/s13018-020-01964-4.

  PMID: 33008432 DERIVED

Related Links

• Online article

MeSH Terms

Conditions

Osteoarthritis

Condition Hierarchy (Ancestors)

Arthritis; Joint Diseases; Musculoskeletal Diseases; Rheumatic Diseases

Study Officials

• Rado Pisot, PhD

  Science and Research Centre Koper

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, CARE PROVIDER
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: This was a randomized, controlled, parallel-group intervention trial to evaluate the benefits of adding MI practice to CPT postoperative rehabilitation program. Eligible patients were randomly assigned to either an intervention group in which MI practice was combined with CPT (MIp), or to a control group which received CPT alone (CON).

Study Record Dates

• First Submitted: September 21, 2018
• First Posted: September 25, 2018
• Study Start: August 21, 2017
• Primary Completion: June 1, 2018
• Study Completion: June 1, 2018
• Last Updated: September 20, 2019

Record last verified: 2019-09

Data Sharing

• IPD Sharing: Will not share

Locations

SL (1)