Biomechanics of Gait Pattern Adaptation in Patients After Total Knee Arthroplasty

NCT ID: NCT01412814

Last Updated: 2015-12-22

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-07-31

Study Completion Date

2014-12-31

Brief Summary

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This study aimed to discover the biomechanics of gait pattern adaptation in patients after a total knee replacement.

The first hypothesis of the project was that center-of-pressure manipulation at the foot during dynamic loading is capable of changing the forces, torques and muscle activation patterns of the lower limb.

The second hypothesis of the project was that patient-specific center-of-pressure manipulation at the foot combined with repetitive perturbation training over time will improve neuromuscular function, barefoot gait patterns, muscle activation patterns, pain, quality of life and energy consumption in patients after a total knee replacement.

Detailed Description

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This study is a randomized prospective controlled study of patients after total knee arthroplasty. Patients will be recruited to the study and divided randomly into an experimental and control group. Both groups will match in terms of gender, age, pathology and clinical assessment. In addition to the intervention of the present study, all patients, whether in the experimental or control group, will carry out the usual physical therapy exercises for total knee arthroplasty as directed by their physician. The patients will be recruited and evaluated prior to surgery and for a follow-up period after surgery.

After surgery, patients in the experimental group will be fitted with a customized biomechanical device worn on the feet (Apos System, Apos - Sports and Medical Technologies Ltd. Hertzlia, Israel). The device is calibrated personally to each patient. By calibrating the device, the center-of-pressure of the foot can be manipulated during all phases of the gait cycle. The device is capable of inducing controlled perturbation during gait. The immediate effects of the device will be evaluated using center-of-pressure measurements, three-dimensional gait analyses and surface electromyography. The patients are instructed to walk with the device according to a therapy protocol (AposTherapy). Patients will be evaluated for changes in gait via three-dimensional gait analyses, muscle activation pattern changes via surface electromyography, pain, quality of life and energy consumption.

The patients in the control group will carry out the same walking exercises as the experimental group, but without the biomechanical intervention device (placebo walking shoe). The patients will be evaluated with the same tools over time as with the experimental group.

Conditions

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Knee Arthroplasty Knee Arthritis Osteoarthritis Osteoarthritis Osteoarthritis, Knee Musculoskeletal Diseases

Keywords

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Total knee arthroplasty Total knee replacement End-stage knee osteoarthritis Gait patterns Neuromuscular education

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors

Study Groups

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Experimental

These patients will carry out the specified intervention of the study with the AposTherapy Biomechanical System in addition to the typical physical therapy regiment prescribed to them by their physician.

Group Type EXPERIMENTAL

AposTherapy Biomechanical System

Intervention Type DEVICE

The device is comprised of four adjustable modular elements attached to foot-worn platforms that are capable of manipulating the foot's center-of-pressure and applying perturbation training throughout the gait cycle. The device allows for neuromuscular training during dynamic loading.

Control

The patients within this group will also carry out the typical physical therapy program for total knee replacement as prescribed by their physician. The patients will carry out a similar therapy program to the experimental group, but without the study intervention device (placebo walking shoe).

Group Type ACTIVE_COMPARATOR

Physical Therapy Program

Intervention Type OTHER

Their therapy program will be similar to the experimental group, but without the treatment device (placebo walking shoe).

Interventions

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AposTherapy Biomechanical System

The device is comprised of four adjustable modular elements attached to foot-worn platforms that are capable of manipulating the foot's center-of-pressure and applying perturbation training throughout the gait cycle. The device allows for neuromuscular training during dynamic loading.

Intervention Type DEVICE

Physical Therapy Program

Their therapy program will be similar to the experimental group, but without the treatment device (placebo walking shoe).

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Patients scheduled for first total knee arthroplasty due to end-stage knee osteoarthritis
* Ambulatory and active patients that can participate in gait analysis

Exclusion Criteria

* Prior joint surgery of either lower extremity, with the exception of arthroscopy
* Unsteady gait
* Back pain
* Neurological, pulmonary or cardiovascular pathologies or risks that may affect long-term performance
* Inability to understand or comply with the treatment protocol
Minimum Eligible Age

40 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Tel-Aviv Sourasky Medical Center

OTHER_GOV

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Biorobotics and Biomechanics Lab, Technion Israel Institute of Technology

Haifa, Israel, Israel

Site Status

Countries

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Israel

Other Identifiers

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0569-10-TLV

Identifier Type: REGISTRY

Identifier Source: secondary_id

TASMC 11 MS 0569-10-TLV CTIL

Identifier Type: -

Identifier Source: org_study_id