Reduction in Knee Adduction Possible via Non-Invasive Biomechanical Training

Reduction in knee adduction moment via non-invasive biomechanical training: A longitudinal gait analysis study

Haim, A,. et al., Journal of Biomechanics 2011

Background
Biomechanical non-invasive interventions have been previously reported to reduce pain and facilitate superior levels of function in patients with medial knee osteoarthritis [OA]. One such treatment is the AposTherapy, a customized program utilizing a foot-worn biomechanical device allowing center of pressure modification and continuous perturbation during gait. The influence of this intervention on objective gait metrics has yet to be determined.

Method
The aim of the current study was to prospectively examine changes in kinetic and kinematic parameters in patients enrolled in this treatment program. Twenty-five females with symptomatic bilateral medial compartment knee OA were enrolled in the customized daily treatment program. All patients underwent barefoot gait analysis testing and completed subjective questionnaires prior to treatment initiation and on two follow-up visits.

Results
Significantly reduced knee adduction moment (KAM) magnitude was noted during bare foot walking after three and nine months of treatment. On average, the knee adduction impulse and the 1st and 2nd KAM peaks were reduced by 13%, 8.4%, and 12.7%, respectively. Furthermore, moment reduction was accompanied by elevated walking velocity, significant pain reduction, and increased functional activity.

Conclusions
These results demonstrate that the Knee Adducting Moment, a key component of the pathomechanic process of medial compartment knee OA, can be successfully altered via non-invasive biomechanical intervention. In addition to functional and symptomatic improvement, such an outcome may lead to delay in disease development and progression.

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