Motor Learning in Knee Osteoarthritis

NCT04445350 | Unknown

• 1 other identifier: StPoltenUAS
• Study Type: interventional
• Target: 50
• Locations: 1 country
• Sites: 1

Brief Summary

Non-surgical treatment options, like exercise therapy, show excellent short-term effects regarding pain reduction and improvement of knee function. However, mid- and long-term effects are missing so far. This might indicate that long-lasting changes in motor-skill performance (Motor Learning) have not occurred. Motor learning is associated with permanent changes in the capability for skilled movement behavior avoiding unfavorable joint loads and inappropriate muscle activation patterns, leading to compensatory movement strategies. One-sided and high repetitive loads in the knee joint could be one reason for the progression of knee osteoarthritis. Physiotherapeutic strategies should therefore be able to stimulate motor learning processes. In physiotherapy, motor learning can be optimized by using instructions and feedback, targeting an external focus of attention, when learning specific movement patterns. This study investigates the effects of a 12 week exercise therapy program, using an external focus of attention, on functional and biomechanical parameters in patients with knee osteoarthritis. To measure possible changes, functional measurements are taking place at baseline, after 6, 12 and 24 weeks. The biomechanical measurements (3D gait analysis) are taking place at baseline, after 12 and 24 weeks.

Conditions

Knee Osteoarthritis; Lower Extremity Biomechanics; Physiotherapy

Keywords

Physiotherapy; External Focus Of Attention; Knee Adduction Moment; Gait Analysis; Osteoarthritis; Motor Learning

Outcome Measures

Primary Outcomes (5)

• Knee Adduction Moment (change over a period of 6 month with 3 measurement dates)

  3D gait analysis during walking

  Baseline, 12 weeks, 24 weeks

• Knee Osteoarthritis Outcome Score (change over a period of 6 month with 4 measurement dates)

  Questionnaire; Minimum value: 0 (highest limitation), Maximum: 100 (no limitation)

  Baseline, 6 weeks, 12 weeks, 24 weeks

• Star Excursion Balance Test (change over a period of 6 month with 4 measurement dates)

  An established test to determine movement control and balance ability. The test person stands on one leg and will is asked to stretch the non supporting leg as far as possible in the directions presented.

  Baseline, 6 weeks, 12 weeks, 24 weeks

• Isometric strength tests (change over a period of 6 month with 4 measurement dates)

  Measures the isometric force of the knee extensors, knee flexors, hip abductors, hip extensors and hip external rotators with a portable dynamometer

  Baseline, 6 weeks, 12 weeks, 24 weeks

• Six minute walking test (change over a period of 6 month with 4 measurement dates)

  The six minute walking test is a reliable measuring tool to examine the distance a person can walk in a given time period.

  Baseline, 6 weeks, 12 weeks, 24 weeks

Study Arms (2)

External focus of attention training program

EXPERIMENTAL

The intervention group receives a strength and neuromuscular training program. The training instructions have an external focus of attention.

Other: External Focus Of Attention

Internal focus of attention training program

ACTIVE COMPARATOR

The control group receives a strength and neuromuscular training program. The training instructions have an internal focus of attention.

Other: Internal Focus Of Attention

Interventions

External Focus Of Attention OTHER

Instructions and feedback are used to direct the learner's focus to an external source (e.g. the effect the intended movement has) promoting long-term learning by stimulating automatic cognitive control processes.

External focus of attention training program

Internal Focus Of Attention OTHER

In contrast, adopting an internal focus of attention (e.g. focus on specific body areal) can disrupt automatic control processes and interfere automatic movement.

Internal focus of attention training program

Eligibility Criteria

• Age: 45 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Kellgren-Lawrence-Score 1-3
• BMI \< 33
• Free range of motion in the knee joint

You may not qualify if:

• Activated knee osteoarthritis
• Lower extremity surgery in the past 6 weeks
• Intake or injection of corticosteroids in the past 3 month
• Long-term medication non-steroidal anti-inflammatory drugs
• Neurological diseases
• Drug or alcohol abuse

Sponsors & Collaborators

• St. Pölten University of Applied Sciences: lead
• Danube University Krems: collaborator
• Karl Landsteiner University of Health Sciences: collaborator
• Orthopedic Hospital Speising: collaborator

Study Sites (1)

Sankt Pölten University of Applied Sciences

Sankt Pölten, Lower Austria, 3100, Austria

RECRUITING

MeSH Terms

Conditions

Osteoarthritis, Knee; Osteoarthritis

Condition Hierarchy (Ancestors)

Arthritis; Joint Diseases; Musculoskeletal Diseases; Rheumatic Diseases

Central Study Contacts

Barbara Wondrasch, PhD

CONTACT

+43/676/847 228 583; barbara.wondrasch@fhstp.ac.at

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: FH-Professor Barbara Wondrasch, PhD

Study Record Dates

• First Submitted: June 9, 2020
• First Posted: June 24, 2020
• Study Start: November 1, 2018
• Primary Completion: February 28, 2022
• Study Completion: April 30, 2022
• Last Updated: June 24, 2020

Record last verified: 2020-06

Locations

AU (1)