Project-ID: LS17-014
Project start: 01. November 2018
Project end: will follow
Runtime: 36 months / ongoing
Funding amount: € 299.781,00

Brief summary

Background
Motor learning (ML) is a discipline grounded in the field of sports psychology and dealing with long-lasting improvements in motor skill performance. In rehabilitative context this is a key factor in order to (re-)learn specific movement patterns or adopt specific movement patterns to perform any physical activity after injuries to the CNS or musculoskeletal system. Further, ML is associated with permanent changes in the capability for skilled movement behavior avoiding unfavorable joint loads, inappropriate muscle activation pattern leading to compensatory movement strategies. Learning processes base upon observable changes in the CNS and have lately been subject of investigation in neuroscientific research with providing evidence by using brain imaging technology. Two different modalities typically used in rehabilitation settings have already been demonstrated to foster ML: by optimizing practice conditions or by a targeted use of instructions and feedback when learning specific movement patterns. In patients with anterior cruciate ligament (ACL) deficient knees, the implementation of targeted instructions and feedback have shown to lead to safer movement patterns regarding jump performance which might be critical to prevent re-injuries. These findings could also be relevant to be people with knee osteoarthritis (KOA), as functional impairments and changes in the CNS are comparable with those from patients with ACL-deficient knees. KOA is degenerative disease with a prominent inflammatory component and particularly younger individuals are affected by restrictions related to sporting-, work- and parenting tasks with respective socio-economic burdens. Current treatment strategies for KOA include surgical and non-surgical interventions. Among the non-surgical treatment options exercise therapy show excellent effects regarding pain reduction and improvement of knee function in the short-term. However, mid- and long-term effects are missing which might indicate that ML, i.e. long-lasting changes in the motor-skill performance, have not occurred.
Aim
To investigate short- and mid-term effects of a ML based neuromuscular training program compared to a conventional neuromuscular training program on pain, knee function and biomechanics during walking in patients with mild to moderate KOA.
Methods
A total of 50 participants (45 and 60 years) with mild to moderate KOA will be included and randomly assigned to an intervention or control group. Both groups will receive the same group-based rehabilitation program including neuromuscular exercises for the knee and hip muscles, but the instructions and feedback will differ between the groups. The duration of the group-based rehabilitation program will be 6 week and is supervised by experienced physiotherapist followed by a 6-weeks period of home-based training program. Evaluation parameters include patient-reported outcome measures functional assessments and biomechanical measures.

Keywords:
Biomechanics