Immediate Effects of rTMS on Excitability of the Quadriceps With Knee Osteoarthritis
Osteoarthritis, Knee
About this trial
This is an interventional treatment trial for Osteoarthritis, Knee focused on measuring TMS, rTMS, corticospinal, quadriceps
Eligibility Criteria
Inclusion Criteria:
- symptomatic knee osteoarthritis primarily involving one leg based on Western Ontario and McMaster Universities Arthritis Index (WOMAC) function subscale score > 10 (out of 100 points, indicating most dysfunction)
- diagnosis of knee osteoarthritis
- opposite knee with WOMAC pain score ≤ 5.
- opposite knee does not have a diagnosis of knee osteoarthritis
Exclusion Criteria:
- conditions affecting the leg other than osteoarthritis
- low blood pressure (< 90 systolic, 60 diastolic) or heart rate (< 60 beats per minute)
- conditions that limit exercise tolerance such as a heart condition
- pregnant or planning to become pregnant in the next 3 months
- conditions that alter sensation and pain processing
- BMI > 35
- severe arthritis in both knees
- history of leg or back surgery in the past year or knee replacement surgery;
- injection in the knee joint in the past 4 weeks
- requires an assistive device to walk
- any contraindications for TMS or rTMS (seizures, metal implants in head, brain related conditions, brain injury, drug or alcohol withdrawal)
- medications that lower seizure threshold
- history of fainting spells (syncope) or low blood pressure
- sleep deprived
- inability to understand and repeat back directions regarding the study
Sites / Locations
- University of North Carolina - Chapel Hill
Arms of the Study
Arm 1
Arm 2
Experimental
Sham Comparator
rTMS and exercise, then Sham rTMS and exercise
Sham rTMS and exercise, then rTMS and exercise
At lab visit, subjects receive repetitive transcranial magnetic stimulation (rTMS) at 10 Hz, 5 sec on, 55 sec off and quadriceps isometric exercise (5% MVIC) for 15 minutes. This is followed by a wash out period of 1 week. At the next lab visit, subjects receive sham rTMS and exercise using the same parameters.
At lab visit, subjects receive sham repetitive transcranial magnetic stimulation (rTMS) at 10 Hz, 5 sec on, 55 sec off and quadriceps isometric exercise (5% MVIC) for 15 minutes. This is followed by a wash out period of 1 week. At the next lab visit, subjects receive the "true" rTMS and exercise using the same parameters.