The study aims at evaluating the effects of one session of Action Observation Training (AOT)
and Motor Imagery (MI) on arthrogenic muscle inhibition (AMI) of the quadriceps (QF) in
subjects with end-stage gonarthrosis.
30 patients with end-stage knee osteoarthritis were enrolled. Patients were randomized in two
groups (experimental group and control group).
Experimental group performed one AOT and MI session with motor content of concentric and
isometric QF contractions, whereas control group underwent a 6-minute sham AOT and MI
session. Every patient was evaluated to assess the percentage of AMI on the QF before (T0)
and after (T1) the assigned treatment following the gold standard Twitch Interpolated
Technique. Both groups sat on an isometric dynamometric chair (COR1, OT-Bioelettronica,
Torino) with a load cell (FORZA, OT-Bioelettronica, Torino) designed to detect and map the
strenght generated by the QF muscle. Upper body movements were limited by crossover shoulder
harnesses, a belt across the abdomen and the subjects were asked to keep their arms crossed
holding onto the harness while performing the evaluation.
Three large electrodes (10x13cm) were positioned over the quadriceps muscle belly. Two sEMG
electrodes (FREEEMG, BTS, Italy) were positioned on the Vastus Medialis and Vastus Lateralis
using the SENIAM protocol.
Right after the first evaluation (T0), both groups performed an AOT session. The experimental
group was shown a video (4 minutes) in which a subject (matched for age, sex, and limb
affected) performed, in third person view, quadriceps concentric contractions for 2 minutes
and isometric contractions for 2 minutes. The video contained visual elements indicating the
maximality of the effort. After both concentric movement video and isometric movement video
the subjects performed a MI session (2 sessions, 1 minute in length each), in which they were
asked to imagine in first person the action just seen in the video.
On the other hand, the control group was shown a video of landscapes (4 minutes in length).
Halfway through and at the end of the video they were asked to imagine what they had just
seen for 1 minute. After the session of AOT and MI (T1) both groups were re-evaluated in the
same way as previously described.