Gait retraining to reduce the knee adduction moment through real-time visual feedback of dynamic knee alignment

Barrios, Joaquin A., Crossley, Kay M. and Davis, Irene S. (2010) Gait retraining to reduce the knee adduction moment through real-time visual feedback of dynamic knee alignment. Journal of Biomechanics, 43 11: 2208-2213. doi:10.1016/j.jbiomech.2010.03.040


Author Barrios, Joaquin A.
Crossley, Kay M.
Davis, Irene S.
Title Gait retraining to reduce the knee adduction moment through real-time visual feedback of dynamic knee alignment
Journal name Journal of Biomechanics   Check publisher's open access policy
ISSN 0021-9290
1873-2380
Publication date 2010-08-10
Year available 2010
Sub-type Article (original research)
DOI 10.1016/j.jbiomech.2010.03.040
Open Access Status DOI
Volume 43
Issue 11
Start page 2208
End page 2213
Total pages 6
Place of publication Kidlington, Oxford, United Kingdom
Publisher Pergamon
Language eng
Abstract Varus knee alignment is a risk factor for medial knee osteoarthritis and is associated with high knee adduction moments. Therefore, reducing the knee adduction moment in varus-aligned individuals with otherwise healthy knees may reduce their risk for developing osteoarthritis. A gait modification that improves dynamic knee alignment may reduce the adduction moment, and systematic training may lead to more natural-feeling and less effortful execution of this pattern. To test these hypotheses, eight healthy, varus-aligned individuals underwent a gait modification protocol. Real-time feedback of dynamic knee alignment was provided over eight training sessions, using a fading paradigm. Natural and modified gait were assessed post-training and after 1 month, and compared to pre-training natural gait. The knee adduction moment, as well as hip adduction, hip internal rotation and knee adduction angles were evaluated. At each training session, subjects rated how effortful and natural-feeling the modified pattern was to execute. Post-training, the modified pattern demonstrated an 8° increase in hip internal rotation and 3° increase in hip adduction. Knee adduction decreased 2°, and the knee adduction moment decreased 19%. Natural gait did not differ between the three visits, nor did the modified gait pattern between the post-training and 1 month visits. The modified pattern felt more natural and required less effort after training. Based on these results, gait retraining to improve dynamic knee alignment resulted in significant reductions in the knee adduction moment, primarily through hip internal rotation. Further, systematic training led to more natural-feeling and less effortful execution of the gait pattern.
Keyword Gait retraining
Adduction moment
Alignment
Real-time feedback
Q-Index Code C1
Q-Index Status Provisional Code
Grant ID 1 S10 RR022396-01
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Health and Rehabilitation Sciences Publications
 
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