Gait Modification Treatment for Knee Osteoarthritis

Effects of Toe-out Gait Modification on Clinical and Biomechanical Measures in People With Knee Osteoarthritis

Knee osteoarthritis (OA) is a costly health condition affecting more than 10% of Canadian adults. Excessive and unbalanced loads passing through the knee joint have been implicated in the progression of OA. Typical conservative treatment of OA has focused on increasing daily activity, without consideration for the underlying joint loading. This study aims to compare a 4-month walking program that aims to increase the angle of the foot (toe-out angle) during walking - a measure shown to reduce joint loading and OA disease progression - while increasing walking time/distance, with a standard walking program that aims to increase walking time/distance. It is predicted that the walking program focusing on increasing toe-out will provide greater reductions in self-reported knee pain and a greater reduction in unfavorable knee joint loading.

Inclusion Criteria:

• aged 50 years and older
• radiographically confirmed medial compartment tibia-femoral knee osteoarthritis
• available for weekly training sessions in the Vancouver British Columbia Canada region
• able to safely perform treadmill walking under therapist supervision

Exclusion Criteria:

• articular cartilage degradation in the lateral tibiofemoral compartment greater than the medial
• inflammatory arthritic condition
• history of knee replacement or arthroscopic knee surgery
• recent use of corticosteroids (oral or via injection)
• inability to ambulate without a gait aid
• non-English speaking
• planning to commence a new treatment approach within the next 4 months