STUDY PROTOCOL article

Front. Aging Neurosci.

Sec. Neurocognitive Aging and Behavior

Volume 17 - 2025 | doi: 10.3389/fnagi.2025.1589645

Differences in sensory-motor cortex activation patterns during level and stair walking in patients with knee osteoarthritis: protocol for a cross-sectional study

Provisionally accepted
Qian  DengQian Deng1Guohua  JinGuohua Jin2Xia  LouXia Lou3Yuwu  DingYuwu Ding2Haichen  XuHaichen Xu2Kun  YangKun Yang2*Bingli  LiuBingli Liu2*Liming  JiangLiming Jiang2*
  • 1Taihu University of Wuxi, Wuxi, Jiangsu, China
  • 2Seventh People's Hospital of Shanghai, Shanghai, China
  • 3Traditional Chinese Medical Hospital of Zhuji, Shaoxing, Zhejiang Province, China

The final, formatted version of the article will be published soon.

Background: Knee osteoarthritis (KOA) is a chronic degenerative disease characterized primarily by pain and joint dysfunction, especially during level and stair walking. Although traditionally classified as a peripheral joint disease, emerging evidence implicates central nervous system (CNS) abnormality in KOA pathogenesis. Our previous studies found that KOA patients showed decreased activation in sensory-motor cortex during isolated joint movements. However, it is not yet clear how brain activation patterns change during level and stair walking. Therefore, this study will investigate the sensory-motor cortex activation in KOA patients during different walking environments, providing evidence for potential targets for KOA central interventions.Methods: This study is designed as a cross-sectional observation, aiming to recruit 20 KOA patients and 20 demographically similar healthy controls (HC). Functional near-infrared spectroscopy (fNIRS) is utilized to assess the hemodynamic responses in the cerebral cortex within the specified regions of interest (ROIs), including the primary somatosensory cortex (S1), primary motor cortex (M1), and somatosensory association cortex (SAC). These measurements will be taken during three motor tasks: level walking, ascending stairs, and descending stairs. Simultaneously, surface electromyography (sEMG) is employed to measure muscle activity of the key muscle groups around the knee joint. The VAS and the WOMAC used to evaluate pain and functional symptoms in KOA patients, respectively. Subsequently, the potential correlations between cerebral hemodynamics changes within ROIs and clinical indicators are analyzed.Discussion: This study, based on "differential activation of the sensory-motor cortex under movement", innovatively observes the relationship between pain and functional impairment in KOA patients and activation levels in specific brain regions across different motor environments. This not only provides a basis for early prediction of KOA onset but also offers potential targets for clinical interventions in KOA. Ultimately, the results of this study may open new perspectives for the rehabilitation of chronic musculoskeletal diseases.

Keywords: knee osteoarthritis, cortex activation, functional near-infrared spectroscopy, Level walking, Stair walking, Surface electromyography Trial registration: ClinicalTrials.gov

Received: 07 Mar 2025; Accepted: 25 Apr 2025.

Copyright: © 2025 Deng, Jin, Lou, Ding, Xu, Yang, Liu and Jiang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Kun Yang, Seventh People's Hospital of Shanghai, Shanghai, China
Bingli Liu, Seventh People's Hospital of Shanghai, Shanghai, China
Liming Jiang, Seventh People's Hospital of Shanghai, Shanghai, China

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