Motor Imagery and Action Observation Training in Total Knee Arthroplasty: A Randomized Controlled Trial

NCT ID: NCT07327190

Last Updated: 2026-01-08

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

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

36 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-10-14

Study Completion Date

2026-05-03

Brief Summary

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This single-center randomized controlled trial aims to evaluate the effects of motor imagery and action observation training on pain, functionality, balance, and fear of movement in patients after total knee arthroplasty (TKA). The study will be conducted at Simav Doç. Dr. İsmail Karakuyu State Hospital Orthopedics Department with a minimum of 40 participants meeting the inclusion criteria. Participants will be randomly assigned to one of three groups: (1) standard physiotherapy, (2) standard physiotherapy plus motor imagery training, or (3) standard physiotherapy plus action observation training.

All interventions will last six weeks. Standard physiotherapy will include ankle pumping, active-assisted hip and knee flexion, isometric and stretching exercises, cryotherapy, gait, and stair training. The motor imagery group will perform guided imagery sessions using audio recordings describing the physiotherapy exercises and daily activities. The action observation group will observe exercise videos corresponding to the physiotherapy program.

The primary outcomes will include pain, functional level, balance, and kinesiophobia. The study aims to determine whether the addition of mental simulation techniques to standard physiotherapy can enhance postoperative recovery and improve functional outcomes in patients undergoing total knee arthroplasty.

Detailed Description

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Conditions

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Knee Osteoarthritis Knee Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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Control Group (Traditional Physiotherapy)

Standard physiotherapy exercise routines will include: ankle pumping exercises, passive/active/active assisted hip flexion (straight leg raise), abduction/adduction, passive/active/active assisted hip-knee flexion (starting from 30°-40°), isometric exercises (quadriceps, adductor, gluteal muscles, hamstrings), cryotherapy (3 times a day), and stretching exercises (hamstring, gastro-soleus), along with walker assistance for standing, walking training, and stair training. In addition, participants in this group will be given recordings containing nature sounds and nature videos to listen to and watch after their exercises.

Group Type ACTIVE_COMPARATOR

Traditional Physiotherapy

Intervention Type OTHER

Patients will be given a standard physiotherapy program consisting of 0-2 weeks and 2-6 weeks, with the first week mainly featuring isometric exercises, stretching exercises, and ankle pumping exercises, and the second-6 weeks transitioning to strengthening exercises.

Motor imagery group

In motor imagery training, participants will visualize standard physiotherapy tasks using audio recordings presented as metaphors. Participants will be asked to fully focus on visualizing the movements in a quiet environment. They will also be asked to imagine different activities from daily life, progressing from simple to more challenging. Patients will undergo imagery training with audio recordings of standard physiotherapy exercises for six weeks. The training content will parallel the standard physiotherapy program. Participants in the motor imagery training group will be provided with audio explanations (mp3 files) of the motor imagery session instructions to continue at home. Patients in this group will also watch videos containing nature visuals.

Group Type EXPERIMENTAL

Motor imagery training

Intervention Type OTHER

In addition to standard visual therapy, patients will be sent audio recordings that allow them to visualize movement; they will also be sent nature videos.

Action observation group

In the action observation group, participants will observe movements by watching videos of standard physiotherapy tasks in addition to standard physiotherapy. The training content will progress in parallel with the standard physiotherapy program. The training content will be prepared by clearly recording frontal or lateral views of all exercises included in the standard physiotherapy curriculum (0-2 week, 2-6 week exercises). Patients in this group will also listen to an audio recording containing relaxing music.

Group Type EXPERIMENTAL

Action observation training

Intervention Type OTHER

In this group, in addition to standard physiotherapy, participants will be given videos showing visuals of the movements and will also be sent audio recordings containing nature sounds during the session.

Interventions

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Traditional Physiotherapy

Patients will be given a standard physiotherapy program consisting of 0-2 weeks and 2-6 weeks, with the first week mainly featuring isometric exercises, stretching exercises, and ankle pumping exercises, and the second-6 weeks transitioning to strengthening exercises.

Intervention Type OTHER

Motor imagery training

In addition to standard visual therapy, patients will be sent audio recordings that allow them to visualize movement; they will also be sent nature videos.

Intervention Type OTHER

Action observation training

In this group, in addition to standard physiotherapy, participants will be given videos showing visuals of the movements and will also be sent audio recordings containing nature sounds during the session.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Those diagnosed with degenerative gonarthrosis and who have experienced unilateral TDA
* Those over 25 years of age
* Those who have obtained a passing score on the Mini Mental Test (\>24)

Exclusion Criteria

* Body mass index of 40 kg/m2 or higher,
* Revision/bilateral TDA,
* Self-reported sensory, cognitive, neurological or motor impairment that would limit participation in the study; history of psychosis; or concomitant diseases that would negatively affect recovery, such as hemiparesis, peripheral neuropathy, lymphedema or lower extremity amputation.
Minimum Eligible Age

25 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Kutahya Health Sciences University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Kütahya Health Sciences University

Kütahya, , Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

Other Identifiers

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KSBU-TDA

Identifier Type: -

Identifier Source: org_study_id

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