title: Effects of contralateral versus ipsilateral cane use on gait in people with knee osteoarthritis.
abstract: OBJECTIVE
  To compare the immediate effects of contralateral versus ipsilateral cane use on spatiotemporal gait parameters and peak vertical ground force in overweight or obese adults with symptomatic knee osteoarthritis (OA).
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  An academic tertiary Veterans Affairs Healthcare Center.
  
  
  METHODS
  Thirty-eight overweight or obese subjects with symptomatic knee OA who had not used a cane for the past 30 days.
  
  
  METHODS
  Spatiotemporal gait data were obtained with an optical motion capture system while subjects walked without a cane, with a cane contralateral to the more painful lower limb, or with a cane ipsilateral to the more painful lower limb at self-selected speeds. An in-shoe dynamic pressure distribution system was used to measure the vertical ground reaction force.
  
  
  METHODS
  Spatiotemporal measures of gait and peak vertical ground reaction force on both lower limbs were recorded for each walking condition: no cane, contralateral cane, and ipsilateral cane.
  
  
  RESULTS
  Walking with a cane either contralateral or ipsilateral to the more symptomatic limb led to significant reductions in gait velocity (14%-16%), cadence (12%-14%), and peak vertical ground reaction force (normalized for body weight; 11%-12%) on the more painful lower limb compared with walking unaided (P < .05). There were no significant differences in the peak vertical ground reaction force on either lower limbs when comparing walking with a cane contralateral to the more painful limb or walking with a cane ipsilateral to the more painful limb. Subjects also experienced a significant decrease in gait velocity with contralateral or ipsilateral cane use compared with walking without a cane; the lower walking speed was due to a decrease in cadence.
  
  
  CONCLUSIONS
  These results support the prescription of a single-point cane to offload a lower limb with painful knee OA by holding the cane either ipsilateral or contralateral to the more painful lower limb.
authors.affiliation: Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA; David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA(∗). Electronic address: meika.fang@va.gov.
authors.forename: Meika A
authors.initials: MA
authors.lastname: Fang
authors.affiliation: Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA(†).
authors.forename: Constance
authors.initials: C
authors.lastname: Heiney
authors.affiliation: Nebraska Biomechanics Core Facility, University of Nebraska at Omaha, Omaha, NE(‡).
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Yentes
authors.affiliation: Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA; David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA(§).
authors.forename: Nancy D
authors.initials: ND
authors.lastname: Harada
authors.affiliation: Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA; David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA(¶).
authors.forename: Sulabha
authors.initials: S
authors.lastname: Masih
authors.affiliation: Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA; School of Science and Technology, Georgia Gwinnett College, Lawrenceville, GA(#).
authors.forename: Karen L
authors.initials: KL
authors.lastname: Perell-Gerson
mesh_terms: D001696:Biomechanical Phenomena; D002183:Canes; D015897:Comorbidity; D005260:Female; D005684:Gait / Q000502:physiology; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000453:epidemiology / Q000503:physiopathology / Q000534:rehabilitation*; D050177:Overweight / Q000453:epidemiology; D011446:Prospective Studies