Effect of motor imagery training on joint function recovery following unicompartmental knee arthroplasty

Abstract

Objective: To retrospectively investigate the effects of motor imagery (MI) training in enhancing knee joint function after unicompartmental knee arthroplasty (UKA).

Methods: This study included 84 patients who underwent UKA at the Orthopedic Joint Department of Shangluo Central Hospital between January 2023 and October 2024. Patients were divided into an experimental group (n = 42) receiving MI training and a control group (n = 42) receiving standard rehabilitation. Clinical outcomes were assessed using the Oxford Knee Score (OKS), Visual Analogue Scale (VAS), range of motion (ROM), Timed Up and Go Test (TUGT), Berg Balance Scale (BBS), and Hospital for Special Surgery Knee Score (HSS) at 1, 6, and 12 months postoperatively. Imaging parameters were also analyzed at 6 months.

Results: Compared to the control group, the experimental group exhibited significantly better clinical outcomes across all measured functions (OKS, VAS, ROM, TUGT, HSS, BBS, Knee flexion angle) at 1, 6, and 12 months postoperatively (all P < 0.01). Specifically, both groups showed significant OKS improvement and VAS reduction post-surgery. The experimental group had more pronounced OKS enhancement and VAS decrease than the control group, especially at 6 and 12 months (all P < 0.001). ROM, HSS, and BBS scores and knee flexion angle progressively increased over time in both groups (all P < 0.05), with the experimental group having higher values at all follow-up times (all P < 0.01). TUGT times were significantly reduced in both groups postoperatively, with greater reduction in the experimental group than the controls at each time point (P < 0.01).

Conclusions: Motor imagery training, when combined with standard postoperative care, significantly enhances knee joint recovery following UKA, reduces patient discomfort, and accelerates functional rehabilitation.

Keywords: Unicompartmental knee arthroplasty; hospital for special surgery; motor imagery; timed up and go test.

Figure 1

Box plots of OKS, VAS, ROM, and HSS scores. A: Box plots of OKS scores in the control group at 1, 6, and 12 months before operation; B: Box plots of OKS scores in the experimental group before surgery and at 1, 6, and 12 months after surgery; C: Box plots of VAS scores in the control group before surgery and at 1, 6, and 12 months after surgery; D: Box plots of VAS scores in the experimental group before surgery and at 1, 6, and 12 months after surgery; E: Box plots of ROM scores in the control group before surgery and at 1, 6, and 12 months after surgery; F: Box plots of ROM scores in the experimental group before surgery and at 1, 6, and 12 months after surgery; G: Box plots of HSS scores in the control group before surgery and at 1, 6, and 12 months after surgery; H: Box plots of HSS scores in the experimental group before surgery and at 1, 6, and 12 months after surgery; Oxford Knee Score, OKS; Visual Analogue Scale, VAS; Range of motion, ROM; Hospital for Special Surgery knee score, HSS.

Figure 2

Comparison of pre-treatment and post-treatment (6 months) knee imaging. A: Preoperative anteroposterior radiograph of Case 1; B: Preoperative lateral radiograph of Case 1; C: Postoperative anteroposterior radiograph of Case 1 (6 months); D: Postoperative lateral radiograph of Case 1 (6 months); E: Preoperative anteroposterior radiograph of Case2; F: Preoperative lateral radiograph of Case 2; G: Postoperative anteroposterior radiograph of Case 2 (6 months); H: Postoperative lateral radiograph of Case 2 (6 months).