- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02036866
Corticospinal Excitability and Rehab in Knee Osteoarthritis
December 10, 2015 updated by: Creighton University
To determine differences in thigh muscle function in individuals with and without knee arthritis, and also determine the effectiveness of common physical therapy interventions on clinical and patient oriented outcomes.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
The primary objective of the proposed research evaluates the concurrent changes in corticospinal excitability and central sensitization of pain pathways for their influence on quadriceps voluntary activation.
A secondary objective is to establish the feasibility of an intervention study to determine if changes in the excitability of these supraspinal motor and sensory processes can be modified by physical therapy interventions targeting pain and muscle strengthening.
We hypothesize that patients with knee osteoarthritis will show measurable deficits in quadriceps voluntary activation that can be explained by lower levels of corticospinal excitability and increased pain sensitization.
A 1 week physical therapy intervention will improve voluntary activation and reduce pain with concurrent changes in underlying motor and sensory processes.
We further hypothesize that part of this improvement will be attributed to positive treatment expectation.
Study Type
Interventional
Enrollment (Actual)
61
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
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Nebraska
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Omaha, Nebraska, United States, 68178
- Creighton University
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
19 years to 65 years (Adult, Older Adult)
Accepts Healthy Volunteers
Yes
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Age 19-65
Grade I or II knee Osteoarthritis confirmed by radiographs or other imaging and at least one of the following:
- Age > 50 years old
- Morning stiffness < 30 minutes
- Crepitus
Meet at least 3 of 6 diagnostic criteria for osteoarthritis:
- Age > 50 years old
- Morning stiffness < 30 minutes
- Crepitus
- Bony tenderness
- Bony enlargement
- No palpable warmth
Exclusion Criteria:
- BMI > 30
- History of traumatic spine or lower extremity injury within the last 6 months
- Previous adverse reaction to electrical stimulation (i.e. burns or hypersensitivity)
- Cardiac pacemaker
- Metal implants in head
- Current pregnancy
- Neurological disorders
- History of seizures
- Unable to give consent or understand the procedures of this study
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Physical Therapy Positive Expectation
The physical therapist will read a script indicating that the intervention is an effective treatment for knee osteoarthritis and is expected to reduce pain and improve strength.
Patients are then instructed on the home exercise program and how to operate the TENS (transcutaneous electrical nerve stimulation) unit.
The duration of intervention is 1 week during which patients will wear then wear the TENS unit for 8 hours per day and perform no more than 3 sets of 10 repetitions of the physical therapy exercises daily.
|
The TENS electrodes will be applied on the medial and lateral superior, as well as the medial and lateral inferior, borders of the patella.
A continuous biphasic pulsatile current (150 Hz, phase duration 150 µs) will be applied at an intensity that produces a comfortable sensation but not a muscle contraction.
The duration of intervention will be 8 hours per day for 1 week.
Other Names:
Patients will be given detailed verbal and hands-on instruction in a home exercise program.
This program will consist of 6 exercises modeled from established protocols focuses on improving lower extremity strength.
Patients will be instructed to do the exercises daily and to progress the exercises over the week for a maximum of 30 repetitions per day for 1 week.
|
Experimental: Physical Therapy Neutral Expectation
The physical therapist will read a script indicating that the intervention may or may not be an effective treatment for knee osteoarthritis and may nor may not reduce pain and improve strength.
Patients are then instructed on the home exercise program and how to operate the TENS unit.
The duration of intervention is 1 week during which patients will wear then wear the TENS unit for 8 hours per day and perform no more than 3 sets of 10 repetitions of the physical therapy exercises daily.
|
The TENS electrodes will be applied on the medial and lateral superior, as well as the medial and lateral inferior, borders of the patella.
A continuous biphasic pulsatile current (150 Hz, phase duration 150 µs) will be applied at an intensity that produces a comfortable sensation but not a muscle contraction.
The duration of intervention will be 8 hours per day for 1 week.
Other Names:
Patients will be given detailed verbal and hands-on instruction in a home exercise program.
This program will consist of 6 exercises modeled from established protocols focuses on improving lower extremity strength.
Patients will be instructed to do the exercises daily and to progress the exercises over the week for a maximum of 30 repetitions per day for 1 week.
|
Experimental: Control- No Intervention
The patients in the control group will be reminded of their appointment in 1 week and instructed to maintain their usual activity level during that time.
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Patients will be instructed to maintain their usual activity level.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in quadriceps force output and voluntary activation
Time Frame: Baseline and following 1 week intervention (2 Study Visits)
|
Quadriceps activation will be estimated by utilizing the burst-superimposition technique on a maximum voluntary isometric contraction (MVIC) and during a resting condition.
The burst-superimposition technique provides the muscle with a percutaneous stimulus to recruit any remaining muscle fibers which have not been stimulated.
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Baseline and following 1 week intervention (2 Study Visits)
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start
November 1, 2013
Primary Completion (Actual)
June 1, 2015
Study Completion (Actual)
June 1, 2015
Study Registration Dates
First Submitted
January 13, 2014
First Submitted That Met QC Criteria
January 13, 2014
First Posted (Estimate)
January 15, 2014
Study Record Updates
Last Update Posted (Estimate)
December 14, 2015
Last Update Submitted That Met QC Criteria
December 10, 2015
Last Verified
December 1, 2015
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 13-16794
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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