From joint degeneration to brain adaptation: Neuroplasticity in knee osteoarthritis

Knee osteoarthritis (KOA) is a chronic condition in which the knee joint progressively deteriorates, causing persistent pain and restrictions in mobility. Neuroplastic changes in the central nervous system, like the dorsolateral prefrontal cortex, periaqueductal gray, and ventral tegmental area, have an important role in the influence of maladaptive pain perception in KOA. Treatment with exercises like resisted exercises and aerobic exercises like Tai Chi, Baduanjin, and cycling enhances adaptive neuroplasticity by improving brain connectivity and motor control. Neuromodulation techniques, such as transcranial direct current stimulation and repetitive transcranial magnetic stimulation, along with electrical stimulation treatments like peripheral electrical stimulation and transcutaneous electrical nerve stimulation, aid these adaptations. Including neuroplasticity-focused rehabilitation techniques in KOA treatment is important for a full recovery.