The Effects of Neuroscience Based Proprioceptive Exercise Training in Elderly With Chronic Knee Pain

This study aim to investigate the effects of nbpet using laser pointer on different fonctional parameters.

Participants will divide into two groups (experimental and control ). Joint position errors will evaluate with the jonit position error assessment method, range of motion with a goniometer, kinesiophobia with the Tampa kinesiophobia scale, pain with the Mc Gill pain scale, quality of life with the Older People Quality of Life questionnaire (OPQoL-brief), and mobility with the time up and go test. Both groups will include in the exercise program with proprioceptive exercise training for 2 sessions per week for 6 weeks. In addition, the experimental group will train with nbpet using laser pointer at the same time.

Properioceptive training A proprioceptive training regimen will establish with Swiss balls. The proprioceptive activities is advanced on a weekly basis in order to test the patient's balance in response. Patients have training in three stages: beginning, intermediate, and advanced. Each exercise will perform as 3x10 repetitions. Between sets, 2-3 minutes rest breaks will given. The beginning phase will applied in the 1st and 2nd weeks, the intemediate phase in the 3rd and 4th weeks, and the advanced phase in the 5th and 6th weeks. The proprioceptive rehabilitation protocol is based on a previous study. All the program will conducted by one experienced physiotherapist.

Neuroscience based proprioceptive training using laser pointer A pre-created wallpaper indicating various directions will fix on the wall 90 cm away from the patient (at the level of the patient's knee when the patient was standing upright) . Then, the laser pointer (producted by NMC training system) will fix to the patient's knee with the help of a velcro so as not to interfere with the patient's knee movement.

At the beginning of the exercise, the patient is asked to move the light on the laser pointer to the midpoint of the wallpaper. The patient is then asked to follow the instructions on the wallpaper by moving the knee in flexion-extension, medio-lateral directions. These instructions are continued throughout the exercise in different directions. Meanwhile, the patient is asked to perform mild cognitive tasks such as counting numbers, names of people starting with any letter, city names or animal names. The training continues for approximately 20 minutes.