Effects of Action Observation Therapy on Pain, Functional Level and Brain Hemodynamic in Patients With Knee Osteoarthritis
Condition: Pain, Chronic; Osteoarthritis, Knee
MeSH terms: Osteoarthritis; Osteoarthritis, Knee; Chronic Pain
Study type: Interventional

Summary: 
      In this project, investigators aim to investigate the effects of action observation therapy
      on pain, fear of movement, functional level and brain hemodynamics in patients with knee
      osteoarthritis. The study is unique in that this method, which has already been used for
      post-surgical or motor healing, aims at long-term administration for the first time with
      chronic pain and objective visualization of the results. This study will create a new
      perspective to understand the physiology of pain, which has attracted much interest in the
      literature in recent years, and will shed light on the studies that can be done in this
      regard. Participants' joint range of motion in the initial assessments will be measured by
      electro-goniometer, muscle strength assessment by JTech hand dynamometer at appropriate
      evaluation positions. In assessing pain, pain levels at rest and during activity will be
      questioned using Visual Analog Scale. Fear of movement of individuals will be assessed via
      Tampa Kinesiophobia Scale and functional levels will be assessed via Western Ontario and
      McMaster Universities Osteoarthritis Index (WOMAC) and the Timed Up and Go Test. Functional
      near infrared spectroscopy (fNIRS) will be used for evaluation of brain hemodynamics. The
      first group, will receive exercises with action observation therapy; and the second group
      will receive only exercises. The exercise programme will be administered under
      physiotherapist supervision for three days a week for six weeks. The evaluations will be
      repeated at the beginning of the study and at the end of the sixth week. Data obtained from
      the study will be analyzed using appropriate statistical methods.
    

Detailed description: 
      Osteoarthritis is a degenerative joint disease associated with pain and disability that
      occurs in 25% of the population over 18 years of age Worldwide. It is expected that
      osteoarthritis will be the fourth most common cause of disability in the World by 2020.
      Osteoarthritic joint has pathological changes such as damage of joint cartilage tissue,
      thickening of the subchondral bone, osteophyte formation, inflammation of synovium at
      different levels, degeneration of ligaments and meniscal structures and hypertrophy of joint
      capsule. In recent years, studies that relate chronic pain to neuroplasticity have
      demonstrated changes in the structure, function and somatotopic organization of the primary
      motor and sensory cortex of osteoarthritis patients with chronic pain. In addition to this,
      osteoarthritis studies showed that the pain does not originate solely from joint problems;
      the central nervous system is also responsible for the formation of pain sensation. Changes
      in the cortical sensorimotor areas include sensory disturbances, perceptual problems
      (differentiation of body image), and motor influences, and these changes are associated with
      severity and duration of pain. When the central nervous system targeted, pain may decrease
      better. Action observation therapy is a method which activates mirror neurons.

      In this project, investigators aim to investigate the effects of action observation therapy
      on pain, fear of movement, functional level and brain hemodynamics in patients with knee
      osteoarthritis. The study is unique in that this method, which has already been used for
      post-surgical or motor healing, aims at long-term administration for the first time with
      chronic pain and objective visualization of the results. This study will create a new
      perspective to understand the physiology of pain, which has attracted much interest in the
      literature in recent years, and will shed light on the studies that can be done in this
      regard.
    

Intervention name(s): Action observation therapy; Exercise
Intervention type(s): Other; Other
Intervention description(s): The normal human movement will be recorded and than the patients will be watched them.; Strengthening and stretching exercise programme focuses on hip and knee muscles
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment