title: Evaluation of immediate impact of cane use on energy expenditure during gait in patients with knee osteoarthritis.
abstract: OBJECTIVE
  The aim of the present study was to assess the immediate impact of cane use on energy expenditure during gait in patients with knee OA analyzing VO(2).
  
  
  METHODS
  An observational, cross-sectional study was carried out on 64 symptomatic patients with a diagnosis of knee OA. The assessment of energy expenditure was performed through an analysis of expired gases using the portable K4 apparatus (Cosmed, Model K4 b2, Italy) during the six-min walk test (6MWT). Two tests were performed with a cane and two without a cane on two different days within a seven-day period.
  
  
  RESULTS
  The patients walked farther on the test without the cane (p<0.001). Oxygen expenditure (VO(2)) and the O(2) cost of walking at the end of the 6MWT increased approximately 50% and 80% during cane-assisted gait when compared to gait without the use of a cane (p<0.001). Pain (Borg scale) decreased approximately 20% at the end of the 6MWT with cane-assisted gait in comparison to gait without a cane (p<0.001).
  
  
  CONCLUSIONS
  Cane use causes an immediate increase in energy expenditure (VO(2)) during gait and O(2) cost of walking and an immediate decrease of pain during gait. It is necessary to do a more prolonged follow up in order to assess the impact of daily cane use on energy expenditure among these patients and determine whether adaptation occurs. Furthermore, it is necessary to study whether daily cane use has a positive impact on important parameters in these patients, such as pain, function and quality of life.
authors.affiliation: Rheumatology Rehabilitation Section, Rheumatology Division, Universidade Federal de Sao Paulo, Brazil.
authors.forename: A
authors.initials: A
authors.lastname: Jones
authors.forename: P G
authors.initials: PG
authors.lastname: Silva
authors.forename: A C
authors.initials: AC
authors.lastname: Silva
authors.forename: M
authors.initials: M
authors.lastname: Colucci
authors.forename: A
authors.initials: A
authors.lastname: Tuffanin
authors.forename: J R
authors.initials: JR
authors.lastname: Jardim
authors.forename: J
authors.initials: J
authors.lastname: Natour
mesh_terms: D000222:Adaptation, Physiological; D000367:Age Factors; D000368:Aged; D002183:Canes / Q000706:statistics & numerical data*; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D004734:Energy Metabolism / Q000502:physiology*; D005080:Exercise Test / Q000379:methods; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000175:diagnosis* / Q000534:rehabilitation; D010101:Oxygen Consumption / Q000502:physiology; D012720:Severity of Illness Index; D012737:Sex Factors