title: Six-week gait retraining program reduces knee adduction moment, reduces pain, and improves function for individuals with medial compartment knee osteoarthritis.
abstract: This study examined the influence of a 6-week gait retraining program on the knee adduction moment (KAM) and knee pain and function. Ten subjects with medial compartment knee osteoarthritis and self-reported knee pain participated in weekly gait retraining sessions over 6 weeks. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores and a 10-point visual-analog pain scale score were measured at baseline, post-training (end of 6 weeks), and 1 month after training ended. Gait retraining reduced the first peak KAM by 20% (p < 0.01) post-training as a result of a 7° decrease in foot progression angle (i.e., increased internal foot rotation), compared to baseline (p < 0.01). WOMAC pain and function scores were improved at post-training by 29% and 32%, respectively (p < 0.05) and visual-analog pain scale scores improved by two points (p < 0.05). Changes in WOMAC pain and function were approximately 75% larger than the expected placebo effect (p < 0.05). Changes in KAM, foot progression angle, WOMAC pain and function, and visual-analog pain score were retained 1 month after the end of the 6-week training period (p < 0.05). These results show that a 6-week gait retraining program can reduce the KAM and improve symptoms for individuals with medial compartment knee osteoarthritis and knee pain.
authors.affiliation: Department of Mechanical Engineering, Stanford University, Stanford, California, USA. pshull@stanford.edu
authors.forename: Pete B
authors.initials: PB
authors.lastname: Shull
authors.forename: Amy
authors.initials: A
authors.lastname: Silder
authors.forename: Rebecca
authors.initials: R
authors.lastname: Shultz
authors.forename: Jason L
authors.initials: JL
authors.lastname: Dragoo
authors.forename: Thor F
authors.initials: TF
authors.lastname: Besier
authors.forename: Scott L
authors.initials: SL
authors.lastname: Delp
authors.forename: Mark R
authors.initials: MR
authors.lastname: Cutkosky
mesh_terms: D000368:Aged; D018771:Arthralgia / Q000503:physiopathology / Q000534:rehabilitation*; D001696:Biomechanical Phenomena / Q000502:physiology; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000503:physiopathology / Q000534:rehabilitation*; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D016059:Range of Motion, Articular / Q000502:physiology*; D012720:Severity of Illness Index; D016896:Treatment Outcome