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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT04877873
Other study ID # KneeOADualTask
Secondary ID
Status Completed
Phase
First received
Last updated
Start date October 19, 2020
Est. completion date August 1, 2022

Study information

Verified date May 2022
Source University of Haifa
Contact n/a
Is FDA regulated No
Health authority
Study type Observational

Clinical Trial Summary

Knee Osteoarthritis (OA) is one of the most common conditions causing disability and limitation in the elderly population, with 13% of women and 10% of men over the age of 60 suffering from symptomatic knee osteoarthritis. Pain and other symptoms of OA significantly affect the quality of life, manifesting itself in pain, decreased range of motion, functional limitation and change in gait patterns. Total Knee Replacement Surgery (TKR) is the most common solution for patients with advanced cartilage erosion and is considered a successful surgery with high satisfaction rates (about 80%). The surgery becomes necessary when pain limits the daily functioning and impairs the quality of life and after the failure of conservative treatment. Still, patients undergoing TKR suffer in the first period after surgery from pain, decreased balance and proprioceptive impairment. Despite the improvement in pain and function, the rates of falls after surgery do not change drastically and remain high. About a third of older adults fall each year, leading to fractures, functional decline and in some cases death. Walking is a complex task, and with advancing age walking becomes less automatic and requires additional attention. Among adults, it is known that an increased risk of falls is associated with reduced ability to perform complex walking tasks, such as walking while talking or crossing obstacles. After TKR, most falls occur while walking due to slipping / tripping. In addition, proprioceptive impairment, pain and poor balance are associated with an increased risk of falling after TKR. The mechanism underlying these effects may be increased allocation of cognitive resources to walking. Thus, this study will examine the ability of people before and after TKR to perform complex walking tasks, in order to examine the change in attention allocation to walking following surgery. It is hypothesized that after surgery, the ability to walk while performing an additional task will be lower than prior to surgery.


Recruitment information / eligibility

Status Completed
Enrollment 38
Est. completion date August 1, 2022
Est. primary completion date August 1, 2022
Accepts healthy volunteers No
Gender All
Age group 65 Years to 90 Years
Eligibility Inclusion Criteria: - Able to walk at least for 1 minute with no assistive device - Able to understand and complete simple instructions Exclusion Criteria: - Diagnosed dementia - Diseases impairing balance - Diagnosed rheumatoid arthritis

Study Design


Related Conditions & MeSH terms


Intervention

Behavioral:
Gait analysis pre- and post- surgery
None (observational)

Locations

Country Name City State
Israel HaEmek Medical Center Afula

Sponsors (2)

Lead Sponsor Collaborator
University of Haifa Emek Medical Center

Country where clinical trial is conducted

Israel, 

Outcome

Type Measure Description Time frame Safety issue
Primary Change in Gait speed Change in gait speed as measured using an instrumented mat One month prior to surgery, 4.5 months post-surgery
Primary Change in gait variability Change in coefficient of variation of stride time and stride length, as measured using an instrumented mat One month prior to surgery, 4.5 months post-surgery
Secondary Change in Joint position sense Estimation of knee position using the Physiological Profile Assessment (PPA). Specifically, the difference between intended knee flexion angle and achieved flexion angle is calculated in degrees (worse performance is identified via larger difference) One month prior to surgery, 4.5 months post-surgery
Secondary Change in Pain, stiffness, physical function The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Is a self-report questionnaire of pain, stiffness and physical function in people with knee osteoarthritis. Scores range 0-20 for pain, 0-8 for stiffness and 0-68 for physical function One month prior to surgery, 4.5 months post-surgery
Secondary Change in dynamic Balance Mini Balance Evaluation Systems Test (Mini-BesTest) is a functional test of dynamic balance. Scores range from 0 to 28, with better scores indicating better balance. One month prior to surgery, 4.5 months post-surgery
Secondary Change in balance self-efficacy The Activities-specific Balance Confidence (ABC) Scale is a self-reported measure of balance self-efficacy. Ranging from 0 to 100, better scores indicate better balance self-efficacy One month prior to surgery, 4.5 months post-surgery
Secondary Change in movement reinvestment Movement reinvestment will be measured using the Movement Specific Reinvestment Scale (MSRS), a self-report measure of conscious monitoring of movement. Scores range from 10 to 60, with higher scores denoting more conscious movement monitoring One month prior to surgery, 4.5 months post-surgery
Secondary Cognitive function Montreal Cognitive Assessment (MoCA) is a test of cognitive function. Ranging from 0 to 30, better scores denote better cognitive function. One month prior to surgery
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