Effects of Movement Retraining on Knee Loading in Individuals With Knee Osteoarthritis
ConditionOsteoarthritis, Knee
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18+
SponsorStanford University
About this trial
This study investigates how well individuals with knee osteoarthritis can learn to alter their calf muscle activation using haptic biofeedback while walking and evaluates how these changes affect knee loading.
Prior research has utilized musculoskeletal simulations to determine that reducing the activation of one of the calf muscles, the gastrocnemius, can have a large impact on reducing knee loading. However, this has not been tested in individuals with knee osteoarthritis. In this study, participants will be trained to alter the activation of their gastrocnemius muscle, by receiving haptic feedback after each step. The feedback will indicate how the participant changed their muscle activation relative to baseline. Some participants will train on a treadmill in the laboratory for up to two sessions, with 30 minutes of walking with feedback in each session. If a participant can learn to adjust their muscle activation in the first training session, they will be able to complete the second training session. Other participants will train outside the laboratory for one session with 30 minutes of walking with feedback to investigate changes in knee loading while using the new walking strategy during over-ground walking.
The movement data collected during the training sessions will be used as inputs to computer simulations of the musculoskeletal system to determine if walking with the new muscle activation strategy reduces knee loading.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Medial and/or lateral compartment knee osteoarthritis
Diagnosed with knee osteoarthritis of at least six months duration
Ambulatory without aids
Able to walk for at least 60 minutes
Disqualifiers
History of symptomatic arthritis in lower limb joints other than the knees
Replacement of any lower extremity joint
Symptoms originating from the patellofemoral joint
Body mass index equal to or greater than 35
Trial design
Design model
Single group
Treatments tested in this trial
Gait retraining
BehavioralChanging muscle coordination while walking
Treatment groups
31 Participants
are divided into 1 treatment groupGroup A: Gait modificationExperimental treatment 1 intervention
Trial outcomes
Primary outcomes
1
Change from baseline in knee contact force
Knee contact force will be evaluated using motion capture data and musculoskeletal modeling and simulations, for participants that are able to reduce gastrocnemius activation.
Time frame
Evaluated during the 30 minutes of feedback walking in the second in-lab session and out-of-lab sessionSecondary outcomes
1
Change from baseline in gastrocnemius activation
Gastrocnemius activation measured through EMG signals.
Time frame
Evaluated during the 30 minutes of feedback walking in the first in-lab session, the second in-lab session, and the out-of-lab session2
Proportion of participants that reduce gastrocnemius activation
Gastrocnemius activation will be measured through electromyography (EMG) signals, and the muscle activation during gait retraining will be compared to baseline walking. Participants that can reduce gastrocnemius activation 10% or more from baseline within 30 minutes of gait retraining will be counted as participants that can reduce gastrocnemius activation out of the total number of participants who try the gait retraining.
Time frame
Evaluated during the 30 minutes of feedback walking in the first in-lab session, the second in-lab session, and the out-of-lab session3
Proportion of participants that reduce knee contact force
For the participants who can successfully reduce gastrocnemius activation from baseline, knee contact force will be calculated using motion capture data and musculoskeletal modeling and simulations. The proportion of participants that reduce knee contact force from baseline during gait retraining out of the total participants that reduce gastrocnemius activation will be evaluated.
Time frame
Evaluated during the 30 minutes of feedback walking in the second in-lab session and the out-of-lab sessionSponsors and contacts
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Source ClinicalTrials.gov