Dual-task Gait Performance in People With Knee Osteoarthritis Before and After Knee Replacement Surgery

NCT04877873 | Completed

• 1 other identifier: KneeOADualTask
• Study Type: observational
• Target: 38
• Locations: 1 country
• Sites: 1

Brief Summary

Knee Osteoarthritis (OA) is one of the most common conditions causing disability and limitation in the elderly population, with 13% of women and 10% of men over the age of 60 suffering from symptomatic knee osteoarthritis. Pain and other symptoms of OA significantly affect the quality of life, manifesting itself in pain, decreased range of motion, functional limitation and change in gait patterns. Total Knee Replacement Surgery (TKR) is the most common solution for patients with advanced cartilage erosion and is considered a successful surgery with high satisfaction rates (about 80%). The surgery becomes necessary when pain limits the daily functioning and impairs the quality of life and after the failure of conservative treatment. Still, patients undergoing TKR suffer in the first period after surgery from pain, decreased balance and proprioceptive impairment. Despite the improvement in pain and function, the rates of falls after surgery do not change drastically and remain high. About a third of older adults fall each year, leading to fractures, functional decline and in some cases death. Walking is a complex task, and with advancing age walking becomes less automatic and requires additional attention. Among adults, it is known that an increased risk of falls is associated with reduced ability to perform complex walking tasks, such as walking while talking or crossing obstacles. After TKR, most falls occur while walking due to slipping / tripping. In addition, proprioceptive impairment, pain and poor balance are associated with an increased risk of falling after TKR. The mechanism underlying these effects may be increased allocation of cognitive resources to walking. Thus, this study will examine the ability of people before and after TKR to perform complex walking tasks, in order to examine the change in attention allocation to walking following surgery. It is hypothesized that after surgery, the ability to walk while performing an additional task will be lower than prior to surgery.

Conditions

Osteoarthritis, Knee

Keywords

Total knee replacement; Cognitive load; Gait; Proprioception; Dual task

Outcome Measures

Primary Outcomes (2)

• Change in Gait speed

  Change in gait speed as measured using an instrumented mat

  One month prior to surgery, 4.5 months post-surgery

• Change in gait variability

  Change in coefficient of variation of stride time and stride length, as measured using an instrumented mat

  One month prior to surgery, 4.5 months post-surgery

Secondary Outcomes (6)

• Change in Joint position sense

  One month prior to surgery, 4.5 months post-surgery

• Change in Pain, stiffness, physical function

  One month prior to surgery, 4.5 months post-surgery

• Change in dynamic Balance

  One month prior to surgery, 4.5 months post-surgery

• Change in balance self-efficacy

  One month prior to surgery, 4.5 months post-surgery

• Change in movement reinvestment

  One month prior to surgery, 4.5 months post-surgery

Interventions

Gait analysis pre- and post- surgery BEHAVIORAL

None (observational)

Eligibility Criteria

• Age: 65 Years - 90 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Candidates for TKR surgery at HaEmek Medical Center.

You may qualify if:

• Able to walk at least for 1 minute with no assistive device
• Able to understand and complete simple instructions

You may not qualify if:

• Diagnosed dementia
• Diseases impairing balance
• Diagnosed rheumatoid arthritis

Sponsors & Collaborators

• University of Haifa: lead
• Emek Medical Center: collaborator

Study Sites (1)

HaEmek Medical Center

Afula, Israel

Location

MeSH Terms

Conditions

Osteoarthritis, Knee

Interventions

Postoperative Period

Condition Hierarchy (Ancestors)

Osteoarthritis; Arthritis; Joint Diseases; Musculoskeletal Diseases; Rheumatic Diseases

Intervention Hierarchy (Ancestors)

Perioperative Period; Surgical Procedures, Operative; Patient Care; Health Services; Health Care Facilities Workforce and Services

Study Design

• Study Type: observational
• Observational Model: CASE ONLY
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: May 2, 2021
• First Posted: May 7, 2021
• Study Start: October 19, 2020
• Primary Completion: August 1, 2022
• Study Completion: August 1, 2022
• Last Updated: May 12, 2023

Record last verified: 2022-05

Data Sharing

• IPD Sharing: Will not share

Locations

IL (1)