Neuromuscular Control and Motor Unit Behavior in Patients With Knee Osteoarthritis

N/ANot Yet RecruitingNCT07544693

Kaohsiung Veterans General Hospital.120 enrolled

Overview

This study aims to examine the effects of moderate-intensity strength training, performed with or without an unloading knee orthosis (valgus-corrective or sham mode), on muscle function, motor unit behavior, and force modulation in patients with moderate knee osteoarthritis

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

120

Conditions

Knee Osteoarthritis (Knee OA)

Interventions

the strengthening programBEHAVIORAL

The isometric knee-extension strengthening program from session 1 to session 9 as follows: 1. Before the first training session each week, one-repetition maximum (1RM) will be measured to determine the training intensity for that week. 2. Training frequency: Three sessions per week on non-consecutive days, for a total of 3 weeks (9 sessions). 3. Training intensity: 60% of 1RM. The goal is to improve quadriceps strength and endurance while reducing joint loading. 4. Each session will consist of four sets: 30 repetitions in the first set and 15 repetitions in sets 2-4. 5. Rest intervals of 30 seconds will be provided between sets, during which the blood-flow-restriction device will remain in place.

Eligibility

Sex: ALLMin age: 55 YearsMax age: 75 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: \- 1. age 55 to 75 years. 2\. Diagnosed with moderate knee traumatic arthritis (Kellgren-Lawrence classification II or III)(experimental group). The control group must not have a diagnosis of osteoarthritis of the knee and must have normal knee joint function. 3\. Physical Health Status: Able to perform basic movements requiring isometric knee contraction tests and electromyography recording. 4\. Able to wear knee orthotics. Exclusion Criteria: * 1\. Knee or lower extremity injury: Recent (within the past 6 months) history of severe injury, fracture, or surgery to the knee or lower extremity. 2\. Other joint disorders: Coexisting joint disorders (such as rheumatoid arthritis or gouty arthritis). 3\. Neuromuscular disorders: Presence of neuromuscular dysfunction, such as stroke, Parkinson's disease, or peripheral neuropathy. 4\. Uncontrolled cardiovascular disease, hypertension, diabetes, or other medical conditions. Taking medications that affect neuromuscular function. 5\. Allergy or intolerance: Allergy to laboratory equipment (such as electromyography electrode gel) or knee brace materials.

Outcomes

Primary Outcomes

maximal voluntary isometric contraction (MVC)

Time frame: Baseline and 3 weeks

The Western Ontario and McMaster Universities Turkish (WOMAC) index

a self-administered questionnaire that assesses three aspects of a patient's health status -pain, stiffness, and physical function - in those with lower limb Osteoarthritis. WOMAC consists of 24 questions, with a total score ranging from 0 to 96 points. there are three subscales: pain (5 questions), stiffness (2 questions), and physical function (17 questions). a five-tier classification of symptomatic severity: minimal or no symptoms (≤24 score), mild (25-41 score), moderate (42-69 score), severe (70-86 score), and extreme (≥87 score).

Time frame: baseline, 3 weeks

The Knee Injury and Osteoarthritis Outcome Score (KOOS)

a knee-specific instrument, developed to assess the patients' opinion about their knee and associated problems. Knee Injury and Osteoarthritis Outcome Score (KOOS) has five subscales: pain (9 questions), symptoms (7 questions), activities of daily living (17 questions), sport/recreation (5 questions), knee-related quality of life (4 questions). The total score of each question (0-4 points) is converted into a score of 0-100, where 100 points represents the best knee health and 0 points represents the worst.

Time frame: Baseline and 3 weeks

Motor Unit Recruitment (amplitude relative to recruitment threshold)

surface EMG decomposition

Time frame: Baseline and 3 weeks

Motor Unit Recruitment (firing rate relative to recruitment threshold)

surface EMG decomposition

Time frame: Baseline and 3 weeks

Data from ClinicalTrials.gov

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