# Movement pattern biofeedback training after total knee arthroplasty

> **NIH NIH R01** · UNIVERSITY OF COLORADO DENVER · 2020 · $622,291

## Abstract

PROJECT SUMMARY
More than 700,000 total knee arthroplasty (TKA) surgeries are performed annually in the United States, with
projections of 3.5 million performed annually by 2030. While recent advances have led to improved TKA
rehabilitation, the persistence of atypical movement patterns after unilateral TKA—characterized by
surgical knee disuse—remains a major problem. Importantly, these atypical movement patterns are
associated with persistent quadriceps weakness and poor physical function. In addition, atypical movement
patterns create compensatory increased loading on the contralateral knee, which may be linked to progression
of contralateral knee osteoarthritis. Coupling contemporary progressive strengthening with innovative
strategies emphasizing motor learning principles to remediate atypical movement patterns has the potential of
advancing rehabilitation to improve movement pattern quality and overall functional recovery after unilateral
TKA. Therefore, the overall aim of this investigation is to perform a randomized controlled trial to
determine if the addition of a novel movement pattern training program (MOVE) to contemporary
progressive rehabilitation improves functional movement pattern quality more than contemporary
progressive rehabilitation alone (CONTROL) after unilateral TKA. Both the MOVE and CONTROL
interventions will be delivered in an outpatient physical therapy setting. Testing will occur pre-operatively and
after TKA at: 2 months (end of intervention), 6 months (primary endpoint), and 2 years. The primary outcome
will be change in peak surgical knee extension moment from baseline to 6 months following TKA. Peak
knee extension moment will be calculated with 3-dimensional instrumented motion analysis during participants
walking, rising from a chair, and stair stepping. The secondary goal is to determine if movement pattern
training improves performance-based and self-report measures physical function, and lessens contralateral
knee OA progression. We expect the MOVE program will result in substantial improvements in surgical knee
extension moments compared to the CONTROL program, and that these improvements will be associated with
improved physical function. Similarly, we expect that greater symmetry in peak knee extension moments will
be correlated with less progression of contralateral knee OA. Finally, an exploratory aim will evaluate how knee
joint forces relate to contralateral knee OA progression over time.

## Key facts

- **NIH application ID:** 9924429
- **Project number:** 5R01AG056585-04
- **Recipient organization:** UNIVERSITY OF COLORADO DENVER
- **Principal Investigator:** Jennifer E. Stevens-Lapsley
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $622,291
- **Award type:** 5
- **Project period:** 2017-09-15 → 2022-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9924429

## Citation

> US National Institutes of Health, RePORTER application 9924429, Movement pattern biofeedback training after total knee arthroplasty (5R01AG056585-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9924429. Licensed CC0.

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