MLKOA: Motor Learning in Knee Osteoarthritis

Sponsor

St. Pölten University of Applied Sciences (Other)

Overall Status

Unknown status

CT.gov ID

NCT04445350

Collaborator

Danube University Krems (Other), Karl Landsteiner University of Health Sciences (Other), Orthopedic Hospital Speising (Other)

Enrollment

Location

Arms

41.9

Anticipated Duration (Months)

1.2

Patients Per Site Per Month

Study Details

Study Description

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.

Condition or Disease	Intervention/Treatment	Phase
Knee Osteoarthritis Lower Extremity Biomechanics Physiotherapy	Other: External Focus Of Attention Other: Internal Focus Of Attention	N/A

Study Design

Study Type:

Interventional

Anticipated Enrollment :

50 participants

Allocation:

Randomized

Intervention Model:

Parallel Assignment

Masking:

Double (Participant, Outcomes Assessor)

Primary Purpose:

Treatment

Official Title:

Motor Learning in Knee Osteoarthritis Therapy - A New Rehabilitation Approach

Actual Study Start Date :

Nov 1, 2018

Anticipated Primary Completion Date :

Feb 28, 2022

Anticipated Study Completion Date :

Apr 30, 2022

Arms and Interventions

Arm	Intervention/Treatment
Experimental: External focus of attention training program The intervention group receives a strength and neuromuscular training program. The training instructions have an external focus of attention.	Other: External Focus Of Attention 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.
Active Comparator: Internal focus of attention training program The control group receives a strength and neuromuscular training program. The training instructions have an internal focus of attention.	Other: Internal Focus Of Attention In contrast, adopting an internal focus of attention (e.g. focus on specific body areal) can disrupt automatic control processes and interfere automatic movement.

Arm

Intervention/Treatment

Experimental: External focus of attention training program

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

Other: External Focus Of Attention

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.

Active Comparator: Internal focus of attention training program

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

Other: Internal Focus Of Attention

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

Outcome Measures

Primary Outcome Measures

Knee Adduction Moment (change over a period of 6 month with 3 measurement dates) [Baseline, 12 weeks, 24 weeks]
3D gait analysis during walking
Knee Osteoarthritis Outcome Score (change over a period of 6 month with 4 measurement dates) [Baseline, 6 weeks, 12 weeks, 24 weeks]
Questionnaire; Minimum value: 0 (highest limitation), Maximum: 100 (no limitation)
Star Excursion Balance Test (change over a period of 6 month with 4 measurement dates) [Baseline, 6 weeks, 12 weeks, 24 weeks]
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.
Isometric strength tests (change over a period of 6 month with 4 measurement dates) [Baseline, 6 weeks, 12 weeks, 24 weeks]
Measures the isometric force of the knee extensors, knee flexors, hip abductors, hip extensors and hip external rotators with a portable dynamometer
Six minute walking test (change over a period of 6 month with 4 measurement dates) [Baseline, 6 weeks, 12 weeks, 24 weeks]
The six minute walking test is a reliable measuring tool to examine the distance a person can walk in a given time period.