Exercise With Dual Task in Knee Osteoarthritis

Study Overview
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Brief Summary
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The purpose of this study is to evaluate the neuromuscular and perceptual responses, pain intensity and performance in patients with severe knee osteoarthritis in a preoperative setting with low-load resistance training with a self-regulated mathematical dual-task.

Official Title
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Neuromuscular and Perceptual Responses, Pain Intensity and Performance During Resistance Exercise With a Self-regulated Dual-task in Patients With Severe Knee Osteoarthritis

Conditions
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Knee Osteoarthritis

Intervention / Treatment
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* Other: Resistance exercise


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: men and women above 55 years old. diagnosed with severe knee osteoarthritis. scheduled for unilateral TKA surgery in a local hospital during 2021- 2022. Exclusion Criteria: pain in the contralateral limb (maximum pain, ≥80 of 100 mm on a VAS during daily activities). another hip or knee joint replacement in the previous year. any medical condition in which exercise was contraindicated. participated in exercise programs (>2 days/week, training at intensities of 10-15RM) in the 6 months prior to the study. history of stroke, brain surgery, major depression, or any self-perceived cognitive alterations that could affect the performance of dual tasks.

Ages Eligible for Study
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Minimum Age: 55 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Regular Task<br>Knee extensions. | Other: Resistance exercise<br>* Do the maximum number of repetitions of externally-resisted (50% 1RM) knee extensions.<br>|
| Experimental: Dual Task<br>Knee extensions while also doing a self-regulated mathematical dual-task. | Other: Resistance exercise<br>* Do the maximum number of repetitions of externally-resisted (50% 1RM) knee extensions.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Self-reported pain intensity (Visual Analogue Scale (VAS) Scale 0-10) | Change from baseline to the end of the session, and the change between the dual-task and the regular condition. | Pre exercise, immediate post session, and 10 minutes after session. | 
| Pressure pain thresholds | Change from baseline to the end of the session, and the change between the dual-task and the regular condition. | Pre exercise, immediate post session, and 10 minutes after session. | 
| HDsEMG | Change from baseline to the end of the session, and the change between the dual-task and the regular condition. | During each experimental session and during each exercise condition. | 
| Performance | Maximum number of exercise repetitions performed. | During each experimental session and during each exercise condition. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Tampa Scale of Kinesiophobia (TSK 11) | Its score range is 11-44, with higher scores reflecting worse condition. | Pre session. | 
| Pain Catastrophizing Scale (PCS) | People are asked to indicate the degree to which they have certain thoughts and feelings when they are experiencing pain using the 0 (not at all) to 4 (all the time) scale. A total score is yielded (ranging from 0-52), along with three subscale scores assessing rumination, magnification and helplessness, with higher scores reflecting worse condition. | Pre session. | 
| Chronic Pain Self-Efficacy Scale (CPSS) | The Chronic Pain Self-Efficacy Scale (CPSS) is designed to measure chronic pain patients' perceived self-efficacy to cope with the consequences of chronic pain. The CPSS measures three domains of pain self-efficacy: pain management, physical functioning, and coping with symptoms. A total score is yielded (ranging from 220-2200), with higher scores reflecting a better condition. | Pre session. | 
| WOMAC questionaire for patients with hip or knee osteoarthritis. | The WOMAC is a disease-specific self-administered questionnaire for patients with hip or knee osteoarthritis. It has a multidimensional scale made up of 24 items grouped into three dimensions: pain (5 items), stiffness (2 items) and physical function (17 items). For each item, it uses a Likert scale with five response levels, representing different degrees of intensity (none, mild, moderate, severe or extreme) that are scored from 0 to 4. The final score for the WOMAC is determined by adding the aggregate scores for pain, stiffness and function. The higher the score, the worse the patient's condition. | Pre session. | 
| Heart Rate | Change from baseline to the end of the session, and the change between the dual-task and the regular condition. | Pre exercise, immediate post session, and 10 minutes after session. | 
| Perceived difficulty of the dual-task. | Based on an 11-point numerical rating scale. | Immediate post exercise. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Knee Osteoarthritis, Electromyography, Muscle Activity, Resistance Training