Investigation of the Effect of Movement Mobilization Concept on Sensory, Pain, Muscle Activation in Patients With Knee Osteoarthritis
NCT Number: NCT06527313
Status: RECRUITING
Study Type: INTERVENTIONAL
Phases: NA
Conditions: Osteo Arthritis Knee|Movement Disorders|Physical Disability|Knee Osteoarthritis
Interventions: BEHAVIORAL: Movement Mobilization Concept, Exercise and Tape|BEHAVIORAL: Sham Movement Mobilization Concept, Exercise and Tape|BEHAVIORAL: Special Exercises
Sponsor: Istinye University
Sex: ALL
Age: ADULT, OLDER_ADULT
Enrollment: 36
Study Design: Allocation: RANDOMIZED|Intervention Model: PARALLEL|Masking: DOUBLE (PARTICIPANT, OUTCOMES_ASSESSOR)|Primary Purpose: TREATMENT
Start Date: 2024-07-25
Completion Date: 2025-07-25
Locations: Istinye University, Istanbul, 34010, Turkey

Summary:
Individuals with knee osteoarthritis are one of the groups most affected by musculoskeletal disorders and experience pain and mobility limitations that significantly limit their daily living activities. Quantitative sensory assessment in individuals with osteoarthritis plays a critical role in evaluating disease progression and treatment effectiveness by objectively measuring changes in sensory perception such as proprioception and nociception. These changes in sensory perception can negatively affect individuals' movement control and balance. In this context, evaluation of quantitative sensory parameters allows the development of more targeted and effective interventions in the rehabilitation processes of individuals with osteoarthritis.

Additionally, electromyographic evaluation in individuals with osteoarthritis analyzes muscle activation levels, providing a better understanding of the impairments in muscle functions of these individuals. EMG data helps to design rehabilitation programs individually by determining to what degree muscles are activated and which muscle groups are more affected. Decreased muscle activation or abnormal muscle activation in individuals with osteoarthritis can negatively affect joint stability and mobility. Therefore, EMG evaluations are an objective method to evaluate the effectiveness of treatment strategies aimed at restoration of muscle functions in individuals with osteoarthritis.

The quantitative sensory and EMG evaluations performed in this project aim to improve the quality of life of individuals by offering innovative approaches in the clinical management of individuals with osteoarthritis. Therefore, these evaluations are of critical importance for the original value and scientific contribution of our project. For these reasons, the selection of individuals with osteoarthritis and the detailed evaluations made on these individuals and its connection with the methods can be considered as the innovative and original aspect of our project.

The aim of this study is to investigate the effect of the Mulligan movement mobilization concept on quantitative sensory parameters, pain and muscle activation levels in patients with knee osteoarthritis.

Primary Outcome Measures: Evaluation of muscle activation:, Evaluation of muscle activation with EMG: It will be evaluated with the Noraxon MyoMuscle system. (Noraxon Inc., Scottsdale, AZ, USA) sEMG (Noraxon myosystem DTS, USA) will be used to measure the electrical activity of the muscles. sEMG data of the muscles will be recorded and muscle activities will be analyzed. Ag/AgC superficial electrodes will be used for sEMG measurements. Superficial 8-channel EMG (Bilateral Quadrieps Femoris (rectus femoris, vastus lateralis, vastus medialis), Biceps femoris (long and short head), Semitendinosus)., 2 mounth|Pain Sensation and Sensory Evaluation, Pressure pain thresholds (BAEs) are measured using a calibrated digital algometer (Algomed/MEDOC) by slowly increasing mechanical pressure at a computer-controlled rate of 1 kg/s.

To elicit temporal summation in all of the above-mentioned regions, mechanical stimulation was applied 10 times using a digital algometer calibrated at 110% of the pressure pain threshold intensity with a 1-second interstimulus interval. When creating temporal summation, the procedure was started at least 2 minutes after the last PPT was measured to ensure that the tests were not contaminated. Before the first stimulus, study participants were asked to verbally indicate their pain levels at the first, fifth and tenth stimuli according to a visual analogue scale (VAS) placed in front of them. VAS is fixed with single digit numbers from 0 to 10, 0 being "no pain", 1-2 "very mild pain", 3-4 "mild pain", 5-6 "moderate pain", 7-8 " "severe pain" and 9-10 as "very severe unbearable pain"., 2 mounth
Secondary Outcome Measures: Muscle strength assessment, Muscle strength assessment and maximum voluntary contraction measurement: with Hand Held Dynamometer Quadriceps and Hamistring muscle strength will be measured with a portable manual muscle strength measuring device (Model 01165, Lafayette, IN, USA). (Layefette Instrument®, Layafette,IN)., 2 mounth|sit and reach test battery, General flexibility of lower extremity muscles: sit and reach test battery

Sit-Reach Test for Flexibility: The participant was asked to sit with his knees straight, without shoes, and to reach as far forward as he could with his arms and palms facing down, without bending his knees. The distance the participant crosses their toes is measured. The test is repeated 3 times and the best result is recorded in cm (Lemmink et al., 2003)., 2 mounth|Timed get up and go test, Patients are instructed to sit upright on a standard stool of approximately 45 cm with their feet flat on the floor. With the 'Start' command, patients are told to get up without holding on, walk towards the object 3 meters away, turn around and sit down again. The entire duration is recorded with a stopwatch (Piva et al., 2004)., 2 mounth|WOMAC, The Western Ontario and McMaster University Arthritis Index (WOMAC) is a patient-reported outcome index for the evaluation of lower extremity OA. The WOMAC index has been used for decades. It is one of the most frequently used outcome measures in research on hip and knee OA. WOMAC has been suggested as one of the highest performing outcome measures for knee and hip OA in terms of reliability, validity, responsiveness, and interpretability (Tüzün et al., 2005)., 2 mounth|Tampa kinesiophobia scale, Chronic pain may cause behavioral changes due to physical and psychological reasons. The Tampa Kinesiophobia Scale score range is 17 to 68, with a higher score indicating increased kinesiophobia. The psychometric properties of the Tampa Kinesiophobia Scale have been tested in many different languages and have been used for many different musculoskeletal pains (Yılmaz et al., 2011)., 2 mounth