Current applications of gait analysis after total knee arthroplasty: A scoping review

Vij, Neeraj; Leber, Christian; Schmidt, Kenneth A.

doi:10.1016/j.jcot.2022.102014

Cited by 7 publications

(1 citation statement)

References 37 publications

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“…85 Similarly, a cross-sectional investigation of adults with medial tibiofemoral OA identified that patients with lower cadence exhibited greater peak KAM, peak KFM, and peak vertical GRF compared to patients with higher cadence. 86 However, most studies to date have only evaluated cadence as a marker of health relevant to physical activity or physical function following knee replacement 84,87 or anterior cruciate ligament reconstruction surgery. 88 It is thought that increasing preferred cadence at a fixed gait speed can decrease the frontal plane moment arm by shifting the center of pressure at initial foot contact toward the center of mass.…”

Section: Rationale and Supportive Evidence For Increasing Cadencementioning

confidence: 99%

Developing gait modification strategies to improve knee joint loading and clinical outcomes in adults with knee osteoarthritis

James

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Background: Knee osteoarthritis (OA) is a leading cause of chronic pain and disability worldwide. Because walking is recommended to manage symptoms, there is a critical need to develop clinically accessible treatment strategies that minimize the aberrant gait mechanics that are associated with the onset and progression of structural and symptomatic knee OA. The central objective of this dissertation research was to provide foundational insights focused on the development of gait modification strategies that reduce knee joint loading and pain.Methods: Adults with clinically defined knee OA were recruited for Aims 1-2. The relation of tibial acceleration to knee pain and impact loading during walking was assessed in a cross-sectional study (Aim 1). A randomized, parallel-group, feasibility trial evaluated knee pain and impact loading following two walking programs, with and without real-time feedback to reduce tibial acceleration (Aim 2). A secondary analysis using data from the Multicenter Osteoarthritis Study investigated the relation of preferred walking cadence to 2-year changes in knee pain and physical function in adults with or at risk for knee OA (Aim 3). The acute effects of increasing preferred walking cadence on knee joint loading, impact loading, and knee pain were determined in a single-visit repeated measures study (Aim 4).Results: Higher peak tibial acceleration during walking was associated with worse knee pain and higher impact loading. However, a gait retraining program aimed at reducing peak tibial acceleration was no more effective than a standard walking program for reducing knee pain and impact loading. Lower preferred walking cadence was associated with an increased risk of incident frequent knee pain and physical function limitations after 2 years. Increasing preferred walking cadence by 2-10% had no immediate effect on proxy measures of knee joint loads or knee pain, but significantly increased measures of impact loading.iv Conclusions: This dissertation research integrated perspectives from clinical biomechanics, motor learning, and epidemiology to enhance our understanding of tibial acceleration and cadence as modifiable gait parameters and how they relate to lower extremity loading, pain, and physical function among individuals with knee OA. Peak tibial acceleration was identified as a proxy measure of impact loading. Low preferred cadence was identified as a risk factor for longitudinal changes in knee pain and physical function. However, the data did not support the use of a gait retraining intervention to reduce tibial acceleration over a standard walking program for reducing impact loading or knee pain, nor did it support the hypothesized reductions in knee joint moments as a result of increasing cadence. Nonetheless, the findings directly inform the clinical management of knee OA, indicating that reducing peak tibial acceleration and increasing preferred cadence are safe, well-tolerated gait modifications that do not exacerbate knee pain. Future research should consider how these ga...

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Section: Rationale and Supportive Evidence For Increasing Cadencementioning

confidence: 99%

Developing gait modification strategies to improve knee joint loading and clinical outcomes in adults with knee osteoarthritis

James

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Patient‐reported outcome measures, the holy grail of outcome assessment: Are they powerful enough to show a difference in knee arthroplasty alignment? A call for more comprehensive and objective data collection

Ostojić,

Violante,

Becker

et al. 2024

Knee surg. sports traumatol. arthrosc.

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Effect of total knee arthroplasty on contralateral knee: A prospective comparative gait analysis of non-operated legs in the Indian population

Tanpure,

Phadnis,

Nagda

et al. 2023

Journal of Clinical Orthopaedics and Trauma

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Current applications of gait analysis after total knee arthroplasty: A scoping review

Cited by 7 publications

References 37 publications

Developing gait modification strategies to improve knee joint loading and clinical outcomes in adults with knee osteoarthritis

Developing gait modification strategies to improve knee joint loading and clinical outcomes in adults with knee osteoarthritis

Patient‐reported outcome measures, the holy grail of outcome assessment: Are they powerful enough to show a difference in knee arthroplasty alignment? A call for more comprehensive and objective data collection

Effect of total knee arthroplasty on contralateral knee: A prospective comparative gait analysis of non-operated legs in the Indian population

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