Adherence to in-home gait retaining using feedback from smartphone app

A high knee adduction moment (KAM) has repeatedly been linked to progression and severity of medial knee osteoarthritis (OA). It places higher than normal loads on the medial compartment of the knee and has become a target for biomechanical intervention. To lower KAM and slow OA progression, gait modification and retraining have been explored. However, the challenge has been incorporating feasible, longitudinal methods for gait retraining. We recently demonstrated that healthy subjects can quickly respond to auditory feedback from a pressure-detecting shoe insole to lower their KAM by shifting their foot pressure medially. Encouraged by these findings, we started a randomized clinical trial enrolling subjects with medial knee OA and outfitting them with a sensor shoe insole and a smartphone feedback kit. Here, we report about our initial experience with adherence to a three-week long programusing this technology for daily in-home gait retraining. We were specifically concerned that negative feedback may cause training avoidance and decreased adherence over time and therefore sought to evaluate iftherewere differences in adherence between this active group and one that handles similar technology without receiving feedback.