Neuromuscular Control in Knee Osteoarthritis

Arthritis is one of the most prevailing causes of disability with knee osteoarthritis (KOA) the most common form. The lifetime risk of developing symptomatic KOA by the age of 85 years is 44.7%, where females are at a greater risk (1.8 times) than male counter parts. KOA is the leading cause of limitations in activities of daily living such as walking and climbing stairs particularly in the elderly. This is primarily due to pain and instability of the joint resulting in buckling of knees caused by muscle weakness, joint stiffness and damage. Patients with KOA have larger variations in muscle strength and are unable to maintain a target force combined with impaired ability to perceive joint movement and positioning suggests impaired neuromuscular control (NC) may influence KOA. NC refers to the nervous system's control over muscle activation contributing to task performance. This study aims to establish the role of loss of NC in biomechanical determinants and health outcomes of KOA.

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Key information

Conditions

Osteoarthritis Knee Arthritis Joint Diseases Musculoskeletal Diseases Osteoarthritis Osteoarthritis, Knee Rheumatic Diseases

Age range

40 year and older

Sex eligibility

All sexes

Study type

Observational

Primary location

Glasgow Caledonian University

Glasgow, G4 0BA, United Kingdom

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Knee osteoarthritis participants only:

Knee Osteoarthritis confirmed by a physician using the American College of Rheumatology (ACR 1986) Criteria
Have unilateral or bilateral knee osteoarthritis
Aged 40 years or over.

Healthy control participants only:

Have no history of unilateral/bilateral knee osteoarthritis
Had no current chronic/stable knee pain in the past 3 months
Aged 40 years or over.

Exclusion criteria

All participants are excluded if they:

Have neuromuscular skeletal injury/illness (e.g.Multiple Sclerosis, Parkinson's disease, Muscular Dystrophy, Cerebral Palsy)
Have had knee surgery, knee arthroplastic surgery and arthroscopic debridement or corrective surgery for knee osteoarthritis in the past 12 months
Have had corticosteroid injections to or around the knee in the past 3 months.
Have unstable heart disease
Previously had a stroke
Have insulin-dependent diabetes
Have osteoporosis
Have a history of falls and other motor deficits
Are unable to walk up and down stairs
Are unable to rise from a chair without the aid of another person
Have an unstable medication schedule and medication that causes dizziness
Have Dementia/Alzheimer's/ an inability to comprehend, follow instructions and give informed consent
Have an inability to lie flat for 60 minutes Have mental in their body.

Treatment and study plan

Primary outcomes

Neuromuscular Control

Time frame: 1 day

Neuromuscular control will be assessed through muscle co-activation index from electromyography (EMG) of the hamstrings, quadriceps and gastrocnemius. The electromechanical delay (delay between the onset of EMG and force), active proprioception and force accuracy and steadiness measure determined from submaximal isometric contractions will be used to determine neuromuscular control

Secondary outcomes

Disease Outcome

Time frame: 1 day

Joint damage scored using the Boston Leeds Osteoarthritis Knee Score (BLOKS) from 1.5T MRI along with pain and function assessed from knee injury and osteoarthritis score (KOOS) and patient reported outcomes measurement information system (PROMIS) will be used to determine disease outcome.

Other outcomes

Determinants of knee osteoarthritis

Time frame: 1 day

Muscle strength (peak force) will be assessed from maximal isometric contractions of the knee, along with passive motion and position sense proprioception as determinants of knee osteoarthritis.

Sponsors and collaborators

Lead sponsor

Martijn Steultjens

Other

Registry information

Acronym: NEKO

Important dates

Study start: 2013
Primary completion: 2015
Study completion: 2015
First posted: Dec 11, 2014
Registry last updated: Mar 3, 2015

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Published trials that share one or more normalized conditions with this study.

Completed