Comparison of the Effectiveness of Single and Dual Task Training Applied to Individuals with Knee Meniscus Lesion

The main function of the meniscus is to transfer and distribute femoral pressure to the tibia. Treatment of meniscus tears is divided into conservative and surgical treatment. The most preferred methods for patients with meniscus lesions include meniscectomy and exercise therapy. The anterior and posterior horns of the meniscus contain numerous mechanoreceptors, including Ruffini endings (slow adapting) and Pacinian corpuscles (fast adapting), which provide information about the position and movement of the joint. Reduced proprioception due to mechanoreceptor damage from meniscus tears may be associated with decreased postural stability, as sensory information associated with a patient's conscious perception of joint movement through mechanoreceptors in the meniscus may contribute to postural stability.

Dual task is based on the simultaneous maintenance of motor-motor or cognitive-motor performance. Dual tasking is used to evaluate the simultaneous performance of a postural task and a motor or cognitive task to examine the interaction or effect of the secondary task on primary task performance. In a purposeful movement, it is necessary to have the ability to adapt to overcome environmental loads and achieve the goal. This also involves performing a cognitive task simultaneously while performing a motor task. In knee meniscus lesions, knee joint position sense and sensory input decrease, walking speed decreases, and attention devoted to walking increases.

Complex movement formation needs to be restructured as a result of sensory and motor disorders. With the loss of movement organization, postural control becomes vulnerable to cognitive attention elements and additional motor tasks. While physical disability creates a burden for the individual and society, it also has a negative impact on executive functions. Robust cognitive processes are essential when performing complex motor tasks and ensuring stable walking. Because the dependence on cognitive resources increases to compensate for the loss of control in postural stability and balance. Although walking and balance are considered to be automatic tasks, performance decreases when processing capacity is exceeded by a simultaneous task. In dual task studies, it has been reported that there is an increase in step time and a decrease in step length due to the increase in the single and double support phases of walking. This situation has been interpreted as a strategy developed to maintain balance in dual task conditions. With the dual task training to be applied to these individuals, it is aimed to ensure that motor control, balance, and the complex movements they encounter in daily life activities can be maintained in balance while walking.

Eligibility Criteria:
Inclusion Criteria:

* 40 to 65 years old
* According to magnetic resonance imaging (MRI) results, there is a maximum of Grade 2 degenerative bilateral meniscus tear
* Having a Standardized Mini Mental Test score of 24 and above
* Volunteering
* Know how to read and write
* Not having vision or hearing problems that cannot be corrected with a device
* Being able to walk independently in society

Exclusion Criteria:

* Not meeting the inclusion criteria
* Having compliance issues or emotional and cognitive problems that will prevent participation in the assessments and clinical practices to be used in the study
* Having problems participating in exercises or follow-ups
* Having had surgery related to the lower extremity
* Having a neuromuscular disease
* Having a history of systemic inflammatory joint disease
* Having a rheumatic disease
* Having an additional pathology in the knee
* Receiving additional treatment