Effectiveness of Graded Motor Imagery Training in Individuals With Foot/Ankle Osteoarthritis: A Randomized Controlled Trial

Socio-demographic assessment form

时间窗: Baseline and after 6 weeks

The names, ages, genders, heights, body weights, dominant side of the lower extremity, occupations, education levels, and medication use of individuals who wish to participate in the study on a voluntary basis will be recorded, along with their phone numbers so that they can be contacted again if necessary. Radiological findings, age, and disease duration will also be included in the clinical evaluation form for individuals with foot/ankle osteoarthritis.

Pain Intensity Assessment

时间窗: Baseline and after 6 weeks

Patients' rest, activity, and night pain will be assessed using the Numerical Rating Pain Scale (NPRS). The NPRS is an 11-point scale scored from 0 to 10. A score of zero (0) indicates "no pain," while a score of 10 indicates "the most severe pain imaginable." Participants will be asked to mark the appropriate score on this scale for their foot/ankle pain.

Pain Threshold Measurement

时间窗: Baseline and after 6 weeks

In this study, the pressure pain threshold (PPT) is defined as the amount of pressure (kg/cm²) at which pressure sensation is converted into pain. PPT measurements will be performed using a mechanical pressure algometer (Commander™ Algometer, JTECH Medical, Inc.). During the measurements, participants will be asked to verbally inform the tester when the applied pressure first causes pain. The device used has a force gauge that measures force in kilograms (kg) and a round rubber tip with a diameter of 1 cm². Pressure application will be performed at a rate of approximately 0.1 kg/cm²/s. Three repetitions will be performed for each anatomical region, and the average of the measurements will be used in the analyses. A 30-second rest period will be provided between each measurement. During foot measurements, participants will be placed in a long sitting position, and the foot being evaluated will be stabilized by the examiner. Referencing Cavanagh (1987), pressure will be applied to the m

Gait Analysis

时间窗: Baseline and after 6 weeks

The BTS G-Walk® Spatio-Temporal Gait Analysis System will be used for gait analysis in the study. Measurements will be performed on a predetermined 10-meter flat walking track . The BTS G-Walk® system works with a wireless sensor (analysis port) placed at the patient's L4-L5 or L5-S1 vertebra level via an elastic belt, and measurement data is transferred to the computer via a Bluetooth connection. This system allows clinicians to analyze spatio-temporal walking parameters obtained during walking, general walking kinematics, and pelvic and spinal movements in three planes. The BTS G-Walk® system provides a detailed analysis by comparing data from the right and left lower extremities with normative values during gait analysis and ensures reliable measurements

Foot Function Index

时间窗: Baseline and after 6 weeks

The Foot Function Index is a self-administered questionnaire that assesses multiple dimensions of foot function. The FFI consists of 23 items divided into three subscales that measure the impact of foot pathology on pain, disability, and activity limitation. The minimum change of clinical significance is 7 points for the total scale. The Foot Function Index is widely used in various pathologies and treatments related to foot and ankle problems, such as congenital, acute and chronic diseases, injuries, and surgical corrections .

Laterality assessment

时间窗: Baseline and after 6 weeks

Laterization assessment will be performed using the Recognise™ application developed by the Neuro Orthopaedic Institute (NOI). There are versions specific to different parts of the body. The "Recognise™ Foot" application will be used in this thesis study. Using the "Vanilla" mode of the NOI program, foot photos will be presented to participants in random order via their phones. Participants will be asked to indicate whether the image shown belongs to the right or left foot. Both response accuracy and reaction time will be recorded during this assessment. Accuracy will be defined as the percentage of images correctly identified; reaction time will represent the time taken by the participant to distinguish between the right and left foot. If participants cannot respond within 5 seconds to four or more consecutive images, this will be considered inattention, and the test will be repeated. The lateralization assessment will be performed three times for each participant, and the avera