Gait Modification and Knee Joint Load

Study Overview
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Brief Summary
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This pilot study aims to assess the effect of a 6-week individualized gait retraining program on knee load and symptoms in persons with knee osteoarthritis (OA).

Detailed Description
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This study aims to pilot-test an individualized gait retraining intervention to reduce knee load, guided by real-time visual feedback of the external knee adduction moment (KAM), a commonly used determinant for medial tibiofemoral (TF) joint load, during walking. Our central hypothesis is that individuals with predominantly medial TF OA can adapt their gait patterns to lower KAM during walking; consequently, reduce knee load and pain.

Official Title
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The Effect of Gait Modification on Knee Joint Load in Persons With Medial Tibiofemoral Osteoarthritis - A Pilot Study

Conditions
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Knee Osteoarthritis

Intervention / Treatment
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* Other: Gait modification


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: people with radiographic TF OA fulfilling American College of Rheumatology classification criteria reporting average knee pain on walking > 3 on an 11-point scale (0-10) in at least one knee pain or tenderness predominantly located on the medial knee. Exclusion Criteria: medial TF joint space width greater than lateral Kellgren/Lawrence (K/L) grade 4 knee surgery or intra-articular corticosteroid injection in the past 6 months uncomfortable walking on treadmill for 20 minutes unable to walk without a walking aide inflammatory arthritis other musculoskeletal or neurological disorders that affect gait patterns currently receiving physical therapy

Ages Eligible for Study
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Minimum Age: 50 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Gait modification<br>In this pilot study, participants modify their gait patterns guided by real-time visual feedback on their medial knee load while walking on an instrumented treadmill. | Other: Gait modification<br>* Individualized gait modifications guided by real-time visual feedback of knee load<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| External knee adduction moment during walking | The external knee adduction moment during walking will be assessed using a10-camera optical motion capture system and force plates. A visual 3D program will be used to compute and plot the pre- and post-intervention external knee adduction moment during walking. | Baseline-to-6-week change | 
| WOMAC (Western Ontario and McMaster Universities) score | WOMAC questionnaire contains 24 questions in three domains of pain (score range 0-20), stiffness (score range 0-8) and physical function (score range 0-68). Higher score indicates worse symptom/function. | Baseline-to-6-week change | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| External knee flexion moment during walking | The external knee flexion moment during walking will be assessed using a10-camera optical motion capture system and force plates. A visual 3D program will be used to compute and plot the pre- and post-intervention external knee flexion moment during walking. | Baseline-to-6-week change | 
| KOOS (Knee Injury and Osteoarthritis Outcome Score) | KOOS questionnaire contains 42 items in 5 domains of pain, other symptoms, function in daily living, function in sport and recreation, and knee-related quality of life. Scores are transformed to a 0-100 scale, with 0 representing extreme knee problems and 100 representing no problems. | Baseline-to-6-week change |