Personalized gait retraining for medial compartment knee osteoarthritis: a randomized controlled trial
Abstract
Summary Background: Retraining individuals with medial compartment knee osteoarthritis to walk with a patient-specific change in their foot angle (i.e., toe-in or toe-out angle) can reduce deleterious joint loading. This study investigated the clinical, biomechanical, and structural efficacy of personalized foot progression angle modifications compared to sham treatment in patients with mild-to-moderate medial compartment knee osteoarthritis. Methods: In this parallel, single-center, participant-blinded randomized controlled trial, we recruited individuals with symptomatic medial compartment knee osteoarthritis in California, USA using online and print media. Eligible participants were randomly assigned 1:1 by a computer to an intervention or sham group. During six walking retraining visits to a university gait laboratory, all participants received real-time biofeedback instructing them to walk consistently with a personalized target foot progression angle. The intervention group’s target was the 5° or 10° change in foot progression angle that maximally reduced their knee loading, and the sham group’s target was their natural foot progression angle. Participants and staff involved in data analysis were blinded to group allocation; staff performing the gait analysis visits were not. Primary outcomes were one-year changes in medial knee pain (numeric rating scale) and medial knee loading (knee adduction moment peak). Secondary outcomes were one-year changes in cartilage…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 34 participants or records.
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