Journal Article

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

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

2025

Overview

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.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Aged / Analysis / Ankle / Arthroplasty, Replacement, Knee - adverse effects / Arthroplasty, Replacement, Knee - rehabilitation / Biomechanical Phenomena / Biomedicine / Clinical trials / Exercise / Female / Gait / Health Sciences / Higher education / Humans / Imagery, Psychotherapy - methods / Informed consent / Intervention / Joint replacement surgery / Knee / Knee Joint - physiopathology / Knee Joint - surgery / Male / Medical research / Medicine / Medicine & Public Health / Medicine, Experimental / Middle Aged / Motor imagery training / Muscle Strength / Muscle synergy / Muscle, Skeletal - physiopathology / Nervous system / Osteoarthritis / Osteoarthritis, Knee - physiopathology / Osteoarthritis, Knee - surgery / Patients / Physical education / Randomized Controlled Trials as Topic / Range of Motion, Articular / Recovery of Function / Rehabilitation / Single-Blind Method / Statistics for Life Sciences / Study Protocol / Time Factors / Total knee arthroplasty / Treatment Outcome / Walking