Knee Osteoarthritis
Conditions
Keywords
knee osteoarthritis, white noise, intrinsic focusing, environmental sound
Brief summary
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
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.
Interventions
OTHERBaseline
Walking without any instruction or sound
OTHERIntrinsic focus
Walking focusing on ensuring equal step lengths and step durations on both sides and symmetry between both steps
OTHERWhite noise
Intrinsic focus accompanied by white noise
OTHERenvironmental sound
Intrinsic focus accompanied by environmental sound
Sponsors
Gazi University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
OTHER
Masking
NONE
Intervention model description
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.
Eligibility
Sex/Gender
ALL
Age
50 Years to 75 Years
Healthy volunteers
No
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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Average step cycle (cycle/second) | Evaluation at first visit of patients meeting the included criteria.12 minutes in total, with 3 minutes of assessment time in each walking condition | After walking in each condition, average step cycle was recorded (total of 4 conditions) |
| Average step length (m) | Evaluation at first visit of patients meeting the included criteria.12 minutes in total, with 3 minutes of assessment time in each walking condition | After walking in each condition, average step length was recorded (total of 4 conditions) |
| Percentage of step length variability (%) | Evaluation at first visit of patients meeting the included criteria. 12 minutes in total, with 3 minutes of assessment time in each walking condition | After walking in each condition, percentage of step length variability was recorded (total of 4 conditions) |
| Percentage of left/right side stepping time (%) | Evaluation at first visit of patients meeting the included criteria.12 minutes in total, with 3 minutes of assessment time in each walking condition | After walking in each condition, percentage of left/right side stepping time was recorded (total of 4 conditions) |
| Ambulation index | Evaluation at first visit of patients meeting the included criteria.12 minutes in total, with 3 minutes of assessment time in each walking condition | After walking in each condition, ambulation index was recorded (total of 4 conditions) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The User Experience Questionnaire Short Form | Evaluation was performed immediately after execution in white noise and environmentel sound conditions | 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. |
Countries
Turkey (Türkiye)
Outcome results
None listed