title: Effects of active feedback gait retraining to produce a medial weight transfer at the foot in subjects with symptomatic medial knee osteoarthritis.
abstract: This study aimed to determine if active feedback gait retraining to produce a medial weight transfer at the foot significantly reduces the knee adduction moment in subjects with medial compartment knee osteoarthritis. Secondarily, changes in peak knee flexion moment, frontal plane knee and ankle kinematics, and center of pressure were investigated. Ten individuals with medial compartment knee osteoarthritis (9 males; age: 65.3 ± 9.8 years; BMI: 27.8 ± 3.0 kg/m2) were tested at self-selected normal and fast speeds in two conditions: Intervention, with an active feedback device attached to the shoe of their more affected leg, and control, with the device de-activated. Kinematics and kinetics were assessed using a motion capture system and force plate. The first peak, second peak, and impulse of the knee adduction moment were significantly reduced by 6.0%, 13.9%, and 9.2%, respectively, at normal speed, with reductions of 10.7% and 8.6% in first peak and impulse at fast speed, respectively, with the active feedback system, with no significant effect on the peak knee flexion moment. Significant reductions in peak varus knee angle and medialized center of pressure in the first half of stance were observed, with reductions in peak varus knee angle associated with reductions in the knee adduction moment. This study demonstrated that active feedback to produce a medial weight-bearing shift at the foot reduces the peaks and impulse of the knee adduction moment in patients with medial compartment knee osteoarthritis. Future research should determine the long-term effect of the active feedback intervention on joint loading, pain, and function. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2251-2259, 2017.
authors.affiliation: Department of Orthopaedic Surgery, Stanford University Medical Center, 496 Lomita Mall, Durand Building 061, Stanford, California.|Veterans Affairs Palo Alto Health Care System, Palo Alto, California.
authors.forename: Jennifer C
authors.initials: JC
authors.lastname: Erhart-Hledik
authors.affiliation: Veterans Affairs Palo Alto Health Care System, Palo Alto, California.|Department of Mechanical Engineering, Stanford University, Stanford, California.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Asay
authors.affiliation: Veterans Affairs Palo Alto Health Care System, Palo Alto, California.
authors.forename: Caitlin
authors.initials: C
authors.lastname: Clancy
authors.affiliation: Department of Orthopaedic Surgery, Stanford University Medical Center, 496 Lomita Mall, Durand Building 061, Stanford, California.|Veterans Affairs Palo Alto Health Care System, Palo Alto, California.
authors.forename: Constance R
authors.initials: CR
authors.lastname: Chu
authors.affiliation: Department of Orthopaedic Surgery, Stanford University Medical Center, 496 Lomita Mall, Durand Building 061, Stanford, California.|Veterans Affairs Palo Alto Health Care System, Palo Alto, California.|Department of Mechanical Engineering, Stanford University, Stanford, California.
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Andriacchi
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D033023:Foot Joints / Q000502:physiology; D005684:Gait; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000628:therapy*; D026741:Physical Therapy Modalities; D016474:Weight-Bearing
keywords: active feedback; gait modification; knee; knee adduction moment; osteoarthritis