Gait modifications (GM) have successfully reduced knee adduction moment (KAM) which is linked with medial compartment knee osteoarthritis (
mKOA). Prior studies have largely relied on single-session designs with healthy participants. Experimental designs with
mKOA patients are necessary to confirm these findings.
PURPOSE: Measure the effect of an GM intervention compared to normal walking on KAM in a randomized sample of
mKOA patients.
METHODS: 7 participants with
mKOA completed the intervention (61 ± 13 yrs, 1.7 ± 0.1 m, 80 ± 23 kg). After baseline, participants were randomized into GM or control (CTRL) group. The GM group performed trunk lean (TL) - leaning the trunk over the affected limb. During training, the TL group was provided with real-time haptic feedback. No feedback provided for the CTRL group. 8-week training sessions were performed with KAM measured baseline, week 5 (PT1), 8 (PT2), and 1-week post-training (PT3). During posttests, participants performed 5 unprompted trial, and then were prompted to perform TL gait for 5 more (TL group). Two-sample randomization tests were performed to determine if mean change in PKAM and TL angle from baseline to posttests were significantly different between groups (p<0.05).
RESULTS: TL angle increased and KAM decreased from baseline to posttest when prompted in the GM group compared to CTRL; however, not all differences reached statistical significance (Table 1).
CONCLUSIONS: Preliminary data suggests that an 8-week intervention is sufficient for
mKOA patients to learn and replicate a modified gait strategy when prompted to reduce KAM. Yet, it appears that there is minimal change in TL angle without prompting, suggesting continued training and/or feedback may be necessary for internalization of the modification.
Table 1. Difference in mean change in KAM and TL from baseline to posttest (GM-CTRL). Positive difference in mean KAM change corresponds to “reduction” in KAM from baseline to posttest (closer to zero).
*p<0.05
| | | | | | |
| PT 1 | PT 2 | PT 3 |
| Unprompted | Prompted | Unprompted | Prompted | Unprompted | Prompted |
| TL Angle (°) | -1.61 | 3.10 | -1.10 | 2.98* | -2.70 | 2.48 |
| PKAM Nm/(kg*m) | 0.01 | 0.06 | -0.02 | 0.03 | 0.07* | 0.11* |
