Osteoarthritis, Knee Clinical Trial
Official title:
Immediate Effects of rTMS on Corticospinal Excitability of the Quadriceps in People With Knee Osteoarthritis
The purpose of the study is to identify things that influence the ability to "turn on" the thigh muscle (quadriceps). The thigh muscle tends to be under active with knee osteoarthritis, which may make it difficult to strengthen the muscle. The investigators are also testing a new technology called repetitive transcranial magnetic stimulation (rTMS) to determine whether it may help "turn up" activity in the under active thigh muscle immediately after its application. rTMS uses a targeted pulsed magnetic field, similar to what is used in an MRI (magnetic resonance imaging) machine to send an electrical signal from the brain to the thigh muscle.
The investigators will recruit up to 20 people with symptomatic knee osteoarthritis. The 20
eligible participants will attend 3 sessions in the laboratory. Session 1 is to collect data
for Aim 1. Sessions 2 and 3 will include the rTMS interventions and data collection for Aim
2.
Aim 1 is a descriptive study to compare the neural (cortical and corticospinal) excitability
of the quadriceps in the symptomatic knee to the asymptomatic knee in participants with knee
osteoarthritis. The investigators will examine the associations between neural excitability
and clinical measures of pain, strength, function, and coping styles.
Aim 2 is a double blind, crossover study design. Each participant will partake in two testing
sessions, spaced 1 week apart. The investigators will evaluate outcome measures prior to and
following the "true" intervention versus the "sham" intervention. The true intervention is
rTMS + exercise. The sham is sham rTMS + exercise. The primary outcome measures are
quadriceps strength, as measured from a maximal isometric voluntary contraction, and
quadriceps central activation ratio (CAR), as calculated from the torque values from the
voluntary strength measurement and a brief, intense electrical stimulus. Secondary measures
evaluate effects of the intervention on 1) clinical measures of pain and functional
performance, 2) corticospinal excitability, and 3) intracortical inhibition and facilitation.
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