A 6-week knee moment and gait pattern biofeedback gait retraining programme in people with knee osteoarthritis and its translation into daily life
Osteoarthritis
EXPERIMENT SETTING All data collection sessions will be conducted in the Applied Biomechanics Suite at the University of Bath. During gait retraining, participants will walk on an instrumented treadmill. During baseline, post-intervention and follow-up assessment, participants will conduct overground walking, sit-to-stand and stair climbing on embedded force platforms in the floor and a portable embedded force platform on stairs. During each session, a fifteen camera, three-dimensional (3D) optoelectronic camera system (Oqus, Qualisys, Sweden) will be used to collect motion capture data. Reflective markers will be placed on the body for static and dynamic measures. Markers will be placed on both legs at the distal phalanx of the first toe, metacarpal phalangeal joints 1 and 5, calcaneus, medial and lateral malleolus of the ankle, medial and lateral joint centre of rotation of the knee, left and right anterior superior iliac spine (ASIS) and posterior superior iliac spine (PSIS), left and right iliac crest, vertebrae C7, suprasternal notch of the manubrium and on the acromion process of the left and right shoulders. Clusters of 4 marker on rigid plates will be placed on the lateral side of the shank and thigh of each leg midway between joints using Velcro straps. At baseline assessment (Week 0), post-training assessment (Week 6) and 1-month follow-up assessment, surface electromyography (EMG) data will be collected from lower limb muscles using surface electrodes, including the following muscles spanning the knee: Vastus lateralis, vastus medialis, rectus femoris, long head of biceps femoris, medial and lateral gastrocnemius, and tibialis anterior. Before placement, electrode locations on each participant’s affected leg will be palpated, shaved, lightly abraded, and cleaned with an alcohol swab. A reference electrode will be placed over the head of the fibula. PROCEDURE Participants will be asked to record a one-week activity log prior to starting the training pro
1. Clinical diagnosis of knee OA 2. Aged between 45 and 69 years 3. BMI <=40.0 kg/m² 4. Current knee pain (minimum VAS score 2) 5. Oxford Knee Score 20 ~ 35 for index knee 6. Able to walk without an assistive device for at least 15 consecutive minutes
1. Body mass index (BMI) >40.0 kg/m² 2. History of knee joint replacement or tibial osteotomy 3. Conditions other than knee OA that could affect walking (e.g. amputation, severe back pain, severe peripheral vascular or heart disease and neurological or developmental disease including multiple sclerosis, Parkinson’s disease, myositis, rickets, or lower limb musculoskeletal surgery within the past 6 months) 4. Inability to adopt an altered gait due to previous injury or surgery on the lower extremities 5. Use of any orthotic equipment 6. Corticosteroid injection within the previous 6 weeks 7. Participation in a new structured exercise program within the past 3 months, or planning to commence exercise or other treatment for knee OA in the next 3 months