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膝关节置换术后运动想象训练对步态和肌肉协同作用的影响:一项随机对照试验的研究方案

Effects of motor imagery training on gait and muscle synergy after total knee arthroplasty: study protocol for a randomized controlled trial.

作者信息

Lu Junyang, Chen Xiaoguang, Tunprasert Thanaporn, Liu Weiguo, Tuo Haowen

机构信息

College of Physical Education, Henan Normal University, Xinxiang, China.

University of Brighton, Village Way, Brighton, BN1 9PH, UK.

出版信息

Trials. 2025 Aug 29;26(1):321. doi: 10.1186/s13063-025-09053-9.

Abstract

BACKGROUND

Total knee arthroplasty has proven to be an effective method for treating severe osteoarthritis, but this procedure may induce abnormal symptoms of gait and muscle synergy after surgery. Motor imagery is a special means of training that can heighten cortical-spinal excitability and spinal transmission efficiency. The training method can fortify muscle strength, enhance joint range of motion, and ameliorate gait and muscle synergy control patterns, all while avoiding postoperative intense pain resulting from high-intensity exercise. This study aims to investigate whether motor imagery training can improve patients' gait function and muscle synergy patterns, and to establish the effectiveness of motor imagery training in fostering postoperative knee joint function recovery in total knee arthroplasty patients.

METHODS

This study will utilize a single-blind randomized clinical trial methodology. The research will aim to recruit forty patients from Guilin Medical College Affiliated Hospital who have undergone total knee arthroplasty and who meet the trial criteria. Random allocation to either the experimental group or the control group will be conducted for these patients. Participants in both the experimental and control groups will receive a 6-week conventional training intervention beginning on the first day after surgery and 5 sessions of rehabilitation training per week. In addition, the participants in the experimental group will receive motor imagery training alongside the conventional training programme. The parameters of gait, muscle synergy, lower limb kinematics and kinetics, isokinetic muscle strength, proprioception, and knee joint scoring will be measured one week before surgery and at 3, 6, and 12 weeks after surgery.

DISCUSSION

This protocol is to evaluate the function of motor imagery training after total knee arthroplasty by analysing the parameters of gait and muscle synergy. The outcomes of this trial are expected to affirm the utility of motor imagery training in the postoperative rehabilitation of total knee arthroplasty patients.

TRIAL REGISTRATION

Chinese Clinical Trial Registry ChiCTR2400082292. Registered on March 26, 2024.

摘要

背景

全膝关节置换术已被证明是治疗重度骨关节炎的有效方法,但该手术可能会在术后引发步态和肌肉协同的异常症状。运动想象是一种特殊的训练方式,可提高皮质-脊髓兴奋性和脊髓传导效率。该训练方法能增强肌肉力量、扩大关节活动范围、改善步态和肌肉协同控制模式,同时避免高强度运动导致的术后剧痛。本研究旨在探讨运动想象训练是否能改善患者的步态功能和肌肉协同模式,并确定运动想象训练在促进全膝关节置换术患者术后膝关节功能恢复方面的有效性。

方法

本研究将采用单盲随机临床试验方法。研究旨在从桂林医学院附属医院招募40名接受全膝关节置换术且符合试验标准的患者。对这些患者进行随机分配,分为实验组或对照组。实验组和对照组的参与者将在术后第一天开始接受为期6周的常规训练干预,每周进行5次康复训练。此外,实验组的参与者将在常规训练方案的基础上接受运动想象训练。将在手术前一周以及术后3周、6周和12周测量步态、肌肉协同、下肢运动学和动力学、等速肌力、本体感觉以及膝关节评分等参数。

讨论

本方案旨在通过分析步态和肌肉协同参数来评估全膝关节置换术后运动想象训练的功能。预计该试验结果将证实运动想象训练在全膝关节置换术患者术后康复中的作用。

试验注册

中国临床试验注册中心ChiCTR2400082292。于2024年3月26日注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2d5/12395707/ded3b7e7d047/13063_2025_9053_Fig1_HTML.jpg

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