2018

Osteoarthritis and Cartilage 26:S376-S377

Pressure-based auditory feedback to reduce knee moments in subjects with medial knee osteoarthritis

J. He, C. Ferrigno, N. Shakoor, M. Wimmer

Rush University Medical Center, Chicago

Schlagwörter

Plantar pressure, Medial knee Osteoarthritis

Plantar pressure, Medial knee Osteoarthritis

Zusammenfassung

The knee adduction moment (KAM) is a surrogate of medial compartment load during gait and is a target ofconservative therapy for medial knee osteoarthritis (OA). Gait modifications have been shown to achieve KAM reduction, however, there has been limited experience with gait retraining methods outside the laboratory. In a previous study, we demonstrated that healthy subjects reduced KAM while walking with pressure-based feedback (PBF) that was designed to medialize center-of-pressure under the foot and impart a subtle gait modification. This prompted the current study, a longitudinal 6-week clinical trial of PBF for KAM reduction in subjects with mild to moderate medial knee OA. In this field study, subjects wear a fully integrated pressuredetecting shoe insole that communicates with a smartphone, which generates PBF in the form ofauditory cues. Here, we report on the initial set-up, training, and response ofsubjects with medial knee OA to PBF in the lab. We tested the hypothesis that pressure-based feedback will reduce peak KAM (pKAM) in a significant majority of the subjects. We also compared the first peak of KAM (KAM1) and the second peak of KAM (KAM2) before and after PBF, and investigated potential adverse effect of PBF on knee flexion moment (KFM).

Moticon's Schlussfolgerungen

This study focuses on knee adduction moment (KAM) as a surrogate for medial compartment load during gait, which is a key target for conservative therapy in medial knee osteoarthritis (OA). The study aimed to explore gait retraining methods outside the laboratory using pressure-based feedback (PBF). A longitudinal 6-week clinical trial involving 13 subjects with mild to moderate medial knee OA was conducted. Subjects wore Moticon sensor insoles that communicated with a smartphone to provide auditory PBF cues. Gait variables and plantar pressure were measured before and after a 30-minute supervised training session with PBF. After training, 10 out of 13 subjects showed a reduction in peak KAM (pKAM) by 11.8%. The study suggests that most participants with knee OA can utilize auditory cues from PBF to reduce pKAM effectively. This gait retraining strategy did not negatively impact KFM, indicating a potential reduction in compressive load at the medial knee.

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