title: Lateral trunk lean gait modification increases the energy cost of treadmill walking in those with knee osteoarthritis.
abstract: OBJECTIVE
  To compare the energy expenditure of increased lateral trunk lean walking - a suggested method of reducing medial compartment knee joint load - compared to normal walking in a population of older adults with medial knee osteoarthritis (OA).
  
  
  METHODS
  Participants completed two randomly-presented treadmill walking conditions: 15 min of normal walking or walking with ten degrees of peak lateral trunk lean. Lateral trunk lean angle was displayed in front of the participant in real-time during treadmill conditions. Energy expenditure (VO2 and METs), heart rate (HR), peak lateral trunk lean angle, knee pain and perceived exertion were measured and differences between conditions were compared using paired t-tests.
  
  
  RESULTS
  Twelve participants (five males, mean (standard deviation (SD)) age 64.1 (9.4) years, body mass index (BMI) 28.3 (4.9) kg/m²) participated. All measures were significantly elevated in the lateral trunk lean condition (P < 0.008), except for knee pain (P = 0.22). Oxygen consumption (VO2) was, on average 9.5% (95% CI 4.2-14.7%) higher, and HR was on average 5.3 beats per minute (95% CI 1.7-9.0 bpm) higher during increased lateral trunk lean walking.
  
  
  CONCLUSIONS
  Increased lateral trunk lean walking on a treadmill resulted in significantly higher levels of steady-state energy expenditure, HR, and perceived exertion, but no difference in knee pain. While increased lateral trunk lean has been shown to reduce biomechanical measures of joint loading relevant to OA progression, it should be prescribed with caution given the potential increase in energy expenditure experienced when it is employed.
authors: Department of Physical Therapy, University of British Columbia, Vancouver, Canada. Electronic address: takacs@alumni.ubc.ca.
authors: J
authors: J
authors: Takacs
authors: Department of Physical Therapy, University of British Columbia, Vancouver, Canada. Electronic address: amyk@alumni.ubc.ca.
authors: A A
authors: AA
authors: Kirkham
authors: Department of Physical Therapy, University of British Columbia, Vancouver, Canada. Electronic address: fraser.perry@alumni.ubc.ca.
authors: F
authors: F
authors: Perry
authors: Department of Physical Therapy, University of British Columbia, Vancouver, Canada. Electronic address: j.brown@alumni.ubc.ca.
authors: J
authors: J
authors: Brown
authors: Department of Physical Therapy, University of British Columbia, Vancouver, Canada. Electronic address: eric.marriott@alumni.ubc.ca.
authors: E
authors: E
authors: Marriott
authors: Department of Physical Therapy, University of British Columbia, Vancouver, Canada. Electronic address: dmonkman@alumni.ubc.ca.
authors: D
authors: D
authors: Monkman
authors: Department of Physical Therapy, University of British Columbia, Vancouver, Canada. Electronic address: jhavey@interchange.ubc.ca.
authors: J
authors: J
authors: Havey
authors: Department of Physical Therapy, University of British Columbia, Vancouver, Canada. Electronic address: stanley.hung@alumni.ubc.ca.
authors: S
authors: S
authors: Hung
authors: Department of Physical Therapy, University of British Columbia, Vancouver, Canada. Electronic address: kristin.campbell@ubc.ca.
authors: K L
authors: KL
authors: Campbell
authors: Department of Physical Therapy, University of British Columbia, Vancouver, Canada. Electronic address: michael.hunt@ubc.ca.
authors: M A
authors: MA
authors: Hunt
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena / Q000502:physiology; D015992:Body Mass Index; D004734:Energy Metabolism / Q000502:physiology*; D005080:Exercise Test; D005260:Female; D005684:Gait / Q000502:physiology*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000150:complications / Q000503:physiopathology*; D010101:Oxygen Consumption / Q000502:physiology; D010146:Pain / Q000209:etiology; D012720:Severity of Illness Index; D016138:Walking / Q000502:physiology; D016474:Weight-Bearing / Q000502:physiology
keywords: Energy expenditure; Gait modification; Knee osteoarthritis; Lateral trunk lean