Brain-Computer Interface Visualization Training to Optimize Muscle Activation Following Orthopaedic Surgery

Summary

After orthopedic surgeries like knee or hip replacement, some patients struggle to fully activate their muscles due to a condition called Arthrogenic Muscle Inhibition (AMI). AMI can slow recovery and make physical therapy less effective. This clinical trial is testing whether a special type of brain training-called neurofeedback visualization training-can help improve muscle activation and speed up recovery.

In this study, patients will receive standard physical therapy after surgery. Half of them will also use a device that helps them "visualize" exercises while wearing a cap that reads brain signals (EEG). The cap tracks brain activity when patients imagine doing specific movements. A computer then shows a virtual avatar performing the movements, giving feedback in real time-like a video game controlled by the brain.

The study includes patients recovering from one of four surgeries:

1. Anterior cruciate ligament reconstruction (ACLR)
2. Total knee arthroplasty (TKA)
3. Total hip arthroplasty (THA)
4. Hip arthroscopy (HA) for femoroacetabular impingement (FAI)

The goal is to see if this training improves muscle strength, movement, and daily function more than standard therapy alone. The study will take place at Rush University Medical Center in Chicago and enroll 240 adults, with 60 patients per type of surgery. Each participant will be followed for up to 6 months after surgery and complete strength tests, movement assessments, and questionnaires about their recovery.

The hope is that combining brain training with physical therapy will lead to faster, more complete recoveries and improve how patients move after surgery.

Conditions

• Anterior Cruciate Ligament Reconstruction
• Total Hip Arthroplasty (THA)
• Total Knee Arthroplasty
• Hip Arthroscopy

Interventions

OTHER

Visualization training with neurofeedback

This technology uses electroencephalography (EEG) to measure brain activity through passive sensors placed on a cap aligned with the motor and frontal cortices. These sensors detect changes in electrical signals when patients imagine performing rehabilitation movements. The EEG data is sent to a computer, where iBrainTech™ software translates it into a virtual avatar that mimics the imagined actions. This real-time feedback-called neurofeedback-helps patients see how well they are engaging their brain during visualization. By turning the process into a video game controlled by brain signals, the platform motivates patients to focus deeply on visualizing the exercises. Repeated activation of these brain regions may help rebuild neuromuscular pathways, improve muscle control, and reduce the effects of Arthrogenic Muscle Inhibition (AMI), a common issue after orthopedic surgery.

OTHER

Standard post-surgical rehabilitation therapy

Patients will follow a standard physical therapy protocol. The protocol will be assigned by their respective surgeon who conducted the procedure and will be specific to the procedure that the patient underwent.

Sponsors & Collaborators

• Rush University Medical Center

  lead OTHER

Principal Investigators

• Jorge Chahla, MD, PhD · Rush University Medical Center

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

TRIPLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-08-14

Primary Completion

2028-05-31

Completion

2028-08-31

FDA Device

Yes

Countries

• United States

Study Locations