Comparison of Progressive Motor Imagery and Sensorimotor Exercises in Knee Osteoarthritis

NCT05850793 | Unknown DMC

• 1 other identifier: ebrugk
• Study Type: interventional
• Target: 54
• Locations: 1 country
• Sites: 1

Brief Summary

Osteoarthritis is the most common type of arthritis, which can affect all joints in the body and includes synovial inflammation, cartilage degeneration, osteophyte formation and bone remodeling in its pathophysiology. Many approaches are used in its treatment, and the effectiveness of exercise in conservative treatment has been proven. Many exercise methods such as strengthening, balance, aquatherapy are applied, but there is no definite consensus on exercise prescribing.Programs that focus on restoring balance and proprioception are called "sensorimotor or neuromuscular trainings". Previous studies have shown that neuromuscular exercises reduce pain, improve function, improve balance, and cause positive biomechanical changes in knee osteoarthritis and meniscus injuries. Progressive Motor Imagery (AMI) is an approach in rehabilitation where the focus is on progressive brain exercise. It is an education that approaches patients with pain, activity limitation and functional loss with a holistic view within the framework of the biopsychosocial model. The aim of this study; to examine the effects of two current treatment programs (AMI, SM training) on symptoms, functionality, balance and proprioception parameters in osteoarthritis rehabilitation.

Conditions

Osteoarthritis, Knee

Keywords

rehabilitation; motor imagery training; sensorimotor training; balance; functional performance

Outcome Measures

Primary Outcomes (1)

• Balance

  For balance and fall risk assessment, the Biodex Balance System (BBS) (Biodex Medical Systems, Inc. 20 Ramsey Road, Shirley, New York) will be used. Computer result will be used to see falling risk and stability postural problems as anteroposterior and mediolateral. In the evaluation, while the patient stands without shoes on the BBS platform, the patients are asked to place their feet on the marked place, hold the BBS monitor and focus. The patient is asked to keep the cursor on the screen in the smallest circle shown on the device screen for 20 seconds while applying surface movements that can move between 20 and 360 degrees that will disrupt postural stability at different levels (12 most stable, 1 most mobile). Based on previous studies, the static assessment will be assessed at level 12, and the dynamic assessment and risk of falling will be assessed at level 8.

  change from baseline to posttreatment 6th weeks , change from posttratment 6th weeks to 12th weeks

Secondary Outcomes (2)

• Pain of joint

  change from baseline to posttreatment 6th weeks , change from posttratment 6th weeks to 12th week

• Proprioception

  change from baseline to posttreatment 6th weeks , change from posttratment 6th weeks to 12th week

Other Outcomes (6)

• Functional Evaluation

  change from baseline to posttreatment 6th weeks , change from posttratment 6th weeks to 12th week

• Range of Motion

  change from baseline to posttreatment 6th weeks , change from posttratment 6th weeks to 12th week

• Cognitive status

  only at baseline evaluation for inclusion criteria (MMSE ≥ 24 point)

Study Arms (3)

Sensorimotor Exercise Training

EXPERIMENTAL

Sensorimotor exercise content has been prepared based on previous sensorimotor, balance and proprioceptive studies in the literature. It is organized as a structured traditional exercise program + SM training content.

Behavioral: Sensorimotor Exercise; Behavioral: Conventional Exercise

Progressive Motor Imagery Training

EXPERIMENTAL

In order to sequentially activate the cortical motor networks and improve cortical organization, a literature-supported program including the components of AMI training (first stage laterality training, second stage motor imagery and third stage mirror therapy) was prepared and a six-week structured exercise program suitable for knee joint treatment + AMI training was prepared.

Behavioral: Conventional Exercise; Behavioral: Progressive Motor Imagery Exercise

Conventional Exercise Training

ACTIVE COMPARATOR

A 6-week program was prepared from traditional treatment exercises based on previous studies in knee osteoarthritis. It consists of progressive muscle strengthening of Quadriceps, Hamstrings and gluteals and also stretching exercises.

Behavioral: Sensorimotor Exercise; Behavioral: Conventional Exercise; Behavioral: Progressive Motor Imagery Exercise

Interventions

Sensorimotor Exercise BEHAVIORAL

Balance, perturbation , aging and strengthing exercise will be performed for knee

Conventional Exercise Training; Sensorimotor Exercise Training

Conventional Exercise BEHAVIORAL

Range of motion, strengthing and stretching exercise will be performed for knee

Also known as: traditional exercise for osteoarthritis

Conventional Exercise Training; Progressive Motor Imagery Training; Sensorimotor Exercise Training

Progressive Motor Imagery Exercise BEHAVIORAL

Different types of exercises will be applied targeting muscle strength, proprioceptive sense or brain neurons for knee

Conventional Exercise Training; Progressive Motor Imagery Training

Eligibility Criteria

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

You may qualify if:

• Diagnosed with knee OA according to the criteria of the American Society of Rheumatology (ACR),
• Stage 2 or 3 according to Kellgren Lawrence radiological staging criteria,
• Between the ages of 50 and 65,
• Body mass index below 35 kg/m²,
• Pain intensity defined by the patient in the last 3 months is at least 3 out of 10 according to NPRS,
• There are no obstacles to being included in the exercise program,
• Patients with a score of at least 24 on the Standardized Mini Mental Test will be included.

You may not qualify if:

• Receiving any physiotherapy program or injection treatment in the last 3 months,
• Having a diagnosis of additional pathology other than OA in the knee, having a history of knee injury / surgery in the past
• Having uncontrollable hypertension, cardiovascular and neurological diseases that will prevent exercise,
• The patient has any vision, hearing or cognitive problems that will prevent him from complying with the treatment,
• Providing ambulation with an assistive device

Sponsors & Collaborators

• Istanbul Medipol University Hospital: lead

Study Sites (1)

Ebru Karadüz

Fatih, Istanbul, 34083, Turkey (Türkiye)

RECRUITING

Related Publications (9)

• Busija L, Bridgett L, Williams SR, Osborne RH, Buchbinder R, March L, Fransen M. Osteoarthritis. Best Pract Res Clin Rheumatol. 2010 Dec;24(6):757-68. doi: 10.1016/j.berh.2010.11.001.

  PMID: 21665124 BACKGROUND

• Fransen M, McConnell S, Harmer AR, Van der Esch M, Simic M, Bennell KL. Exercise for osteoarthritis of the knee: a Cochrane systematic review. Br J Sports Med. 2015 Dec;49(24):1554-7. doi: 10.1136/bjsports-2015-095424. Epub 2015 Sep 24.

  PMID: 26405113 BACKGROUND

• Cross M, Smith E, Hoy D, Nolte S, Ackerman I, Fransen M, Bridgett L, Williams S, Guillemin F, Hill CL, Laslett LL, Jones G, Cicuttini F, Osborne R, Vos T, Buchbinder R, Woolf A, March L. The global burden of hip and knee osteoarthritis: estimates from the global burden of disease 2010 study. Ann Rheum Dis. 2014 Jul;73(7):1323-30. doi: 10.1136/annrheumdis-2013-204763. Epub 2014 Feb 19.

  PMID: 24553908 BACKGROUND

• Sharma L. Osteoarthritis of the Knee. N Engl J Med. 2021 Jan 7;384(1):51-59. doi: 10.1056/NEJMcp1903768. No abstract available.

  PMID: 33406330 BACKGROUND

• Zhang W, Doherty M, Peat G, Bierma-Zeinstra MA, Arden NK, Bresnihan B, Herrero-Beaumont G, Kirschner S, Leeb BF, Lohmander LS, Mazieres B, Pavelka K, Punzi L, So AK, Tuncer T, Watt I, Bijlsma JW. EULAR evidence-based recommendations for the diagnosis of knee osteoarthritis. Ann Rheum Dis. 2010 Mar;69(3):483-9. doi: 10.1136/ard.2009.113100. Epub 2009 Sep 17.

  PMID: 19762361 BACKGROUND

• Dominguez-Navarro F, Igual-Camacho C, Silvestre-Munoz A, Roig-Casasus S, Blasco JM. Effects of balance and proprioceptive training on total hip and knee replacement rehabilitation: A systematic review and meta-analysis. Gait Posture. 2018 May;62:68-74. doi: 10.1016/j.gaitpost.2018.03.003. Epub 2018 Mar 5.

  PMID: 29525292 BACKGROUND

• Moseley GL. Graded motor imagery for pathologic pain: a randomized controlled trial. Neurology. 2006 Dec 26;67(12):2129-34. doi: 10.1212/01.wnl.0000249112.56935.32. Epub 2006 Nov 2.

  PMID: 17082465 BACKGROUND

• Baird CL, Sands L. A pilot study of the effectiveness of guided imagery with progressive muscle relaxation to reduce chronic pain and mobility difficulties of osteoarthritis. Pain Manag Nurs. 2004 Sep;5(3):97-104. doi: 10.1016/j.pmn.2004.01.003.

  PMID: 15359221 BACKGROUND

• Kolasinski SL, Neogi T, Hochberg MC, Oatis C, Guyatt G, Block J, Callahan L, Copenhaver C, Dodge C, Felson D, Gellar K, Harvey WF, Hawker G, Herzig E, Kwoh CK, Nelson AE, Samuels J, Scanzello C, White D, Wise B, Altman RD, DiRenzo D, Fontanarosa J, Giradi G, Ishimori M, Misra D, Shah AA, Shmagel AK, Thoma LM, Turgunbaev M, Turner AS, Reston J. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Care Res (Hoboken). 2020 Feb;72(2):149-162. doi: 10.1002/acr.24131. Epub 2020 Jan 6.

  PMID: 31908149 RESULT

MeSH Terms

Conditions

Osteoarthritis, Knee

Condition Hierarchy (Ancestors)

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

Study Officials

• EBRU KARADÜZ, PhD(c)

  İstanbul Medipol University

  PRINCIPAL INVESTIGATOR

• Sena TOLU, Asist Prof

  Medipol Mega Hospital

  STUDY CHAIR

• Candan Algun, Prof

  İstanbul Medipol University

  STUDY CHAIR

Central Study Contacts

EBRU KARADÜZ, MSc

CONTACT

+905346434872; ebrugulek94@gmail.com

Sena TOLU, Assist Prof

CONTACT

05054424722; stolu@medipol.edu.tr

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Masking Details: participants and the researcher who evaluated the analysis are blind to the study
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Physiotherapist (MSc ) / PhD (continous) / Lecturer Ebru Gülek Karadüz

Model Details: A randomized controlled trial

Study Record Dates

• First Submitted: March 18, 2023
• First Posted: May 9, 2023
• Study Start: May 15, 2023
• Primary Completion: June 30, 2024
• Study Completion: December 30, 2024
• Last Updated: June 13, 2023

Record last verified: 2023-06

Locations

TU (1)