The Effect of Intrinsic Focus on Gait Cycle and the Possible Confounding Effect of Noise in Patients With Knee Osteoarthritis

NCT ID: NCT06065410

Last Updated: 2023-10-03

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

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-02-01

Study Completion Date

2023-04-30

Brief Summary

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Patients with knee osteoarthritis may develop an antalgic gait over time due to pain in the knee, characterized by a decrease in the stance phase and stride length on the painful side. Gait asymmetry, which may lead to different musculoskeletal problems in the future, is observed in the patients. Gait symmetry can be achieved with gait retraining, and effective focus is required during training.

In the literature, there are many studies of the positive effects of white noise on focusing, but there are also studies that report that it reduces focusing.

Today, exercise training is usually performed in rehabilitation units or on treadmills. As there are important differences between walking on a treadmill and walking outdoors in terms of noise, uneven ground and visual stimuli, the place where walking training is performed does not reflect the outdoor environment.

It was aimed to investigate the effect of internal focusing on gait cycle and the effect of white noise and environmental sound on internal focusing in patients with knee osteoarthritis

Detailed Description

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A total of 40 patients between the ages of 50 and 75 years, who were admitted to the outpatient clinic of Gazi University Faculty of Medicine, Department of Physical Medicine and Rehabilitation or hospitalized in the ward and diagnosed with knee osteoarthritis according to ACR knee osteoarthritis criteria and had a Kellgren Lawrence staging of at least 2, were included.

The demographic data of the patients who were evaluated with the Hearing Handicap Inventory for the Elderly Screening Version (HHIE-S) and had adequate hearing level were recorded, bilateral true leg lengths were measured and detailed knee examinations were performed. Lequesne Knee Osteoarthritis Severity Index, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Lower Extremity Functional Scale (LEFS), 30 Second Sit to Stand Test and Timed Up and Go Test were applied to the patients who met the inclusion and exclusion criteria.

Patients walked at a speed of 0.40-0.45 m/s on a treadmill (Biodex Gait Trainer) where gait parameters were collected. Each patient walked at a constant speed for three minutes each in the baseline (without any instruction or sound), intrinsic focus (focusing on ensuring equal step lengths and step durations on both sides and symmetry between both steps), white noise (intrinsic focus accompanied by white noise) and environmental sound (intrinsic focus accompanied by environmental sound) conditions. After walking in each condition, gait parameters ( average step cycle, average step length, percentage of step length variability, percentage of left/right side stepping time and ambulation index) were recorded. The User Experience Questionnaire Short Form was adapted for our study to assess patients' experiences during intrinsically focused walking in white noise and environmental sound conditions. Patients were asked to rate their walking periods in white noise and environmental sound conditions in terms of inhibiting-supportive, inefficient-efficient, complex-simple, confusing-clear, boring-exciting, uninteresting-interesting, traditional-unique, and familiar-unusual characteristics.

Conditions

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Knee Osteoarthritis

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Between the ages of 50 and 75 years, who were admitted to the outpatient clinic of Gazi University Faculty of Medicine, Department of Physical Medicine and Rehabilitation or hospitalized in the ward and diagnosed with knee osteoarthritis according to ACR knee osteoarthritis criteria and had a Kellgren Lawrence staging of at least 2, were included.
Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Patients with knee osteoarthritis

Group Type EXPERIMENTAL

Baseline

Intervention Type OTHER

Walking without any instruction or sound

Intrinsic focus

Intervention Type OTHER

Walking focusing on ensuring equal step lengths and step durations on both sides and symmetry between both steps

White noise

Intervention Type OTHER

Intrinsic focus accompanied by white noise

environmental sound

Intervention Type OTHER

Intrinsic focus accompanied by environmental sound

Interventions

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Baseline

Walking without any instruction or sound

Intervention Type OTHER

Intrinsic focus

Walking focusing on ensuring equal step lengths and step durations on both sides and symmetry between both steps

Intervention Type OTHER

White noise

Intrinsic focus accompanied by white noise

Intervention Type OTHER

environmental sound

Intrinsic focus accompanied by environmental sound

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Stable general condition
* Good cooperation
* Diagnosed with knee osteoarthritis according to ACR criteria
* At least stage 2 unilateral or bilateral knee osteoarthritis according to Kellgren Lawrence staging
* Individuals \>50 years of age

Exclusion Criteria

* Hearing Impairment Scale ≥ 26
* Presence of a neurological, cardiac or orthopedic pathology that prevents walking
* The presence of another pathology other than knee osteoarthritis that affects the knee and causes pain
* Presence of diseases such as osteoarthritis, gout, rheumatoid arthritis affecting other joints in the lower extremity
Minimum Eligible Age

50 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Gazi University

OTHER

Sponsor Role lead

Responsible Party

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Dilek Sayar

Research Assistant Medical Doctor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Gazi University Faculty of Medicine

Ankara, , Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

References

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Roos EM, Arden NK. Strategies for the prevention of knee osteoarthritis. Nat Rev Rheumatol. 2016 Feb;12(2):92-101. doi: 10.1038/nrrheum.2015.135. Epub 2015 Oct 6.

Reference Type BACKGROUND
PMID: 26439406 (View on PubMed)

Lespasio MJ, Piuzzi NS, Husni ME, Muschler GF, Guarino A, Mont MA. Knee Osteoarthritis: A Primer. Perm J. 2017;21:16-183. doi: 10.7812/TPP/16-183.

Reference Type BACKGROUND
PMID: 29035179 (View on PubMed)

Turcot K, Armand S, Lubbeke A, Fritschy D, Hoffmeyer P, Suva D. Does knee alignment influence gait in patients with severe knee osteoarthritis? Clin Biomech (Bristol). 2013 Jan;28(1):34-9. doi: 10.1016/j.clinbiomech.2012.09.004. Epub 2012 Oct 12.

Reference Type BACKGROUND
PMID: 23063098 (View on PubMed)

Neumann DL. A Systematic Review of Attentional Focus Strategies in Weightlifting. Front Sports Act Living. 2019 Aug 9;1:7. doi: 10.3389/fspor.2019.00007. eCollection 2019.

Reference Type BACKGROUND
PMID: 33344931 (View on PubMed)

Johnson L, Burridge JH, Demain SH. Internal and external focus of attention during gait re-education: an observational study of physical therapist practice in stroke rehabilitation. Phys Ther. 2013 Jul;93(7):957-66. doi: 10.2522/ptj.20120300. Epub 2013 Apr 4.

Reference Type BACKGROUND
PMID: 23559523 (View on PubMed)

Wulf G, Prinz W. Directing attention to movement effects enhances learning: a review. Psychon Bull Rev. 2001 Dec;8(4):648-60. doi: 10.3758/bf03196201.

Reference Type BACKGROUND
PMID: 11848583 (View on PubMed)

Faisal AA, Selen LP, Wolpert DM. Noise in the nervous system. Nat Rev Neurosci. 2008 Apr;9(4):292-303. doi: 10.1038/nrn2258.

Reference Type BACKGROUND
PMID: 18319728 (View on PubMed)

Muzet A. Environmental noise, sleep and health. Sleep Med Rev. 2007 Apr;11(2):135-42. doi: 10.1016/j.smrv.2006.09.001. Epub 2007 Feb 20.

Reference Type BACKGROUND
PMID: 17317241 (View on PubMed)

Shidara M, Richmond BJ. Effect of visual noise on pattern recognition. Exp Brain Res. 2005 May;163(2):239-41. doi: 10.1007/s00221-005-2230-0. Epub 2005 Mar 15.

Reference Type BACKGROUND
PMID: 15912370 (View on PubMed)

Helps SK, Bamford S, Sonuga-Barke EJ, Soderlund GB. Different effects of adding white noise on cognitive performance of sub-, normal and super-attentive school children. PLoS One. 2014 Nov 13;9(11):e112768. doi: 10.1371/journal.pone.0112768. eCollection 2014.

Reference Type BACKGROUND
PMID: 25393410 (View on PubMed)

van Kempen E, van Kamp I, Lebret E, Lammers J, Emmen H, Stansfeld S. Neurobehavioral effects of transportation noise in primary schoolchildren: a cross-sectional study. Environ Health. 2010 Jun 1;9:25. doi: 10.1186/1476-069X-9-25.

Reference Type BACKGROUND
PMID: 20515466 (View on PubMed)

Other Identifiers

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Gazi University PMR.

Identifier Type: -

Identifier Source: org_study_id

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