Motor Imagery and Rehabilitation of Orthopaedic Patients

Study Overview
=================
Brief Summary
-----------------
Motor imagery is increasingly used as a plasticity-booster to complement conventional rehabilitation. Here the investigators test the hypothesis that the combination of mental training with conventional rehabilitation may speed up the recovery in patients with total knee arthroplasty. The investigators also characterize the brain correlates of such recovery with imagery tasks for virtual reality environments.

Official Title
-----------------
Can Mental Training Based on Motor Imagery Speed up the Rehabilitation of Walking? Efficacy of a Controlled Procedure and Neurofunctional Bases of Recovery in Patients With Total Knee Arthroplasty

Conditions
-----------------
Orthopedic Disorder

Intervention / Treatment
-----------------
* Behavioral: Mental training based on Motor Imagery
* Behavioral: Cognitive training
* Behavioral: Evaluation of gait abilities


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Right handed No contraindication to the fMRI exam Exclusion Criteria: Contraindication to the fMRI exam

Ages Eligible for Study
-----------------
Minimum Age: 45 Years
Maximum Age: 80 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| TKA patients - Experimental Group<br> | Behavioral: Mental training based on Motor Imagery<br>* Patients of the experimental group will be instructed to imagine walking, from a first person perspective, focusing on the kinaesthetic sensations typically associated with the movement. The motor imagery training will be performed using the support of a laptop, on which there will be presented complex static scenes, representing different kind of paths with different landmarks to reach during the mental walking.<br>Behavioral: Evaluation of gait abilities<br>* All the subjects included in the trial will undergo a series of behavioral test for the evaluation of gai abilities<br>|
| TKA patients - Control Group 1<br> | Behavioral: Cognitive training<br>* Patients of the control group 1 will undergo a general cognitive training, not based on motor imagery.<br>Behavioral: Evaluation of gait abilities<br>* All the subjects included in the trial will undergo a series of behavioral test for the evaluation of gai abilities<br>|
| Healthy subjects - Control Group 2<br> | Behavioral: Evaluation of gait abilities<br>* All the subjects included in the trial will undergo a series of behavioral test for the evaluation of gai abilities<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Speed of walking | The speed of walking recorded in total knee arthroplasty patients of the experimental group will be compared with the same measure recorded in both control groups. | 20 days | 
| BOLD (blood oxygen level-dependent) activity | The BOLD activity recorded during functional magnetic resonance imaging (fMRI) in TKA patients of the experimental group will be compared with the same measure recorded in both control groups. | 20 days |