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Using an integrated motor imagery and physical training intervention after knee injury : An interim analysis of the MOTIFS randomised controlled trial

Cederström, Niklas LU orcid ; Nilsson, Gustav ; Dahan, Rickard ; Granér, Simon LU and Ageberg, Eva LU orcid (2024) In BMJ Open Sport and Exercise Medicine 10(4).
Abstract

Objectives Physical function is often a main focus of knee injury rehabilitation, but recent recommendations include increasing attention to psychological factors. We have developed the MOTor Imagery to Facilitate Sensorimotor re-learning (MOTIFS) training model which integrates dynamic motor imagery into physical rehabilitation. The objective is to report interim analysis results of an adaptive randomised controlled trial regarding the pre-defined continuation criteria. Methods Following a 12-week intervention in which participants were randomised to either MOTIFS or Care-as-Usual training, n=42 people undergoing rehabilitation for a traumatic knee injury were assessed for change from baseline to follow-up in psychological readiness to... (More)

Objectives Physical function is often a main focus of knee injury rehabilitation, but recent recommendations include increasing attention to psychological factors. We have developed the MOTor Imagery to Facilitate Sensorimotor re-learning (MOTIFS) training model which integrates dynamic motor imagery into physical rehabilitation. The objective is to report interim analysis results of an adaptive randomised controlled trial regarding the pre-defined continuation criteria. Methods Following a 12-week intervention in which participants were randomised to either MOTIFS or Care-as-Usual training, n=42 people undergoing rehabilitation for a traumatic knee injury were assessed for change from baseline to follow-up in psychological readiness to return to activity, using the ACL Return to Sport after Injury Scale (ACL-RSI), and side hop limb symmetry index. Continuation criteria included differences of ≥5 points in ACL-RSI and ≥8 points in side hop limb symmetry index in favour of the MOTIFS group. If these were not met, ≥5 points change in enjoyment was acceptable. Results Pre-defined continuation criteria were not met for ACL-RSI (mean difference -8.1 (SE 4.1)), side hop limb symmetry index (mean difference 4.4 (SE 7.8)), nor enjoyment (mean difference 3.9 (SE 4.5)), indicating that major modifications are required for continuation of the MOTIFS trial. Conclusion While results of this interim analysis did not show differences in psychological readiness to return to activity or side hop performance, previous research shows that the MOTIFS model is positive and enjoyable. Further research is warranted to evaluate more appropriate outcomes related to the holistic nature of physical and psychological readiness to return to activity. Trial registration number NCT03473821.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Exercise rehabilitation, Knee injuries, Psychology, Rehabilitation, Sport and exercise psychology
in
BMJ Open Sport and Exercise Medicine
volume
10
issue
4
article number
e002064
publisher
BMJ Publishing Group
external identifiers
  • pmid:39371411
  • scopus:85206294492
ISSN
2055-7647
DOI
10.1136/bmjsem-2024-002064
project
Motor Imagery to Facilitate Sensorimotor Relearning (MOTIFS): Integrating dynamic motor imagery in current treatment of knee injury
language
English
LU publication?
yes
id
e1d91186-3b07-4ff2-a6bc-b4c830062591
date added to LUP
2024-12-05 08:36:56
date last changed
2025-07-18 03:18:45
@article{e1d91186-3b07-4ff2-a6bc-b4c830062591,
  abstract     = {{<p>Objectives Physical function is often a main focus of knee injury rehabilitation, but recent recommendations include increasing attention to psychological factors. We have developed the MOTor Imagery to Facilitate Sensorimotor re-learning (MOTIFS) training model which integrates dynamic motor imagery into physical rehabilitation. The objective is to report interim analysis results of an adaptive randomised controlled trial regarding the pre-defined continuation criteria. Methods Following a 12-week intervention in which participants were randomised to either MOTIFS or Care-as-Usual training, n=42 people undergoing rehabilitation for a traumatic knee injury were assessed for change from baseline to follow-up in psychological readiness to return to activity, using the ACL Return to Sport after Injury Scale (ACL-RSI), and side hop limb symmetry index. Continuation criteria included differences of ≥5 points in ACL-RSI and ≥8 points in side hop limb symmetry index in favour of the MOTIFS group. If these were not met, ≥5 points change in enjoyment was acceptable. Results Pre-defined continuation criteria were not met for ACL-RSI (mean difference -8.1 (SE 4.1)), side hop limb symmetry index (mean difference 4.4 (SE 7.8)), nor enjoyment (mean difference 3.9 (SE 4.5)), indicating that major modifications are required for continuation of the MOTIFS trial. Conclusion While results of this interim analysis did not show differences in psychological readiness to return to activity or side hop performance, previous research shows that the MOTIFS model is positive and enjoyable. Further research is warranted to evaluate more appropriate outcomes related to the holistic nature of physical and psychological readiness to return to activity. Trial registration number NCT03473821.</p>}},
  author       = {{Cederström, Niklas and Nilsson, Gustav and Dahan, Rickard and Granér, Simon and Ageberg, Eva}},
  issn         = {{2055-7647}},
  keywords     = {{Exercise rehabilitation; Knee injuries; Psychology; Rehabilitation; Sport and exercise psychology}},
  language     = {{eng}},
  month        = {{10}},
  number       = {{4}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{BMJ Open Sport and Exercise Medicine}},
  title        = {{Using an integrated motor imagery and physical training intervention after knee injury : An interim analysis of the MOTIFS randomised controlled trial}},
  url          = {{http://dx.doi.org/10.1136/bmjsem-2024-002064}},
  doi          = {{10.1136/bmjsem-2024-002064}},
  volume       = {{10}},
  year         = {{2024}},
}