Effects of Toe-In and Wider Step Width in Stair Ascent with Different Knee Alignments

Bennett, Hunter J.; Zhang, Songning; Shen, Guangping; Weinhandl, Joshua T.; Paquette, Max R.; Reinbolt, Jeffrey A.; Coe, Dawn P.

doi:10.1249/mss.0000000000001140

Cited by 23 publications

(7 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous studies investigating gait modifications in KOA have focused on reporting changes in KAM under standardized laboratory conditions [2][3][4][5][6]24,25] and most trained the gait modifications within a single session (and single-task conditions) only. These studies provide evidence of fast-learning but not of slow-learning, required for longerterm retention of the learnt gait pattern.…”

Section: Discussionmentioning

confidence: 99%

“…People with medial knee osteoarthritis (KOA) often have an increased knee adduction moment (KAM), which is associated with faster progression of the disease [1]. Modifying the foot progression angle (FPA) during gait can reduce the KAM [2][3][4][5][6][7][8][9]. Real-time biofeedback can be used to train gait modifications [3][4][5][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The learning process of gait retraining using real-time feedback in patients with medial knee osteoarthritis

et al. 2018

View full text Add to dashboard Cite

The objective of this study was to investigate the learning process of knee osteoarthritis (KOA) patients learning to change their foot progression angle (FPA) over a six-week toe-in gait training program. Sixteen patients with medial KOA completed a six-week toe-in gait training program with real-time biofeedback. Patients walked on an instrumented treadmill while receiving real-time feedback on their foot progression angle (FPA) with reference to a target angle. The FPA difference (difference between target and actual FPA) was analyzed during i) natural walking, ii) walking with feedback, iii) walking without feedback and iv) walking with a dual-task at the start and end of the training program. Self-reported difficulty and abnormality and time spent walking and training were also analyzed. The FPA difference during natural walking was significantly decreased from median 6.9 to median 3.6° i.e. by 3.3° in week six (p < 0.001); adding feedback reduced FPA difference to almost zero. However the dual-task condition increased the FPA difference at week one compared to the feedback condition (median difference: 1.8°, p = 0.022), but after training this effect was minimized (median difference: 0.6°, p = 0.167). Self-reported abnormality and difficulty decreased from median 5 to 3 and from median 6 to 3 on the NRS respectively (p < 0.05). Patients with medial KOA could reduce the FPA difference during natural walking after the gait retraining program, with some evidence of a reduction in the cognitive demand needed to achieve this. Automation of adaptions might need support from more permanent feedback using wearable technologies.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The learning process of gait retraining using real-time feedback in patients with medial knee osteoarthritis

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Generally speaking toe-in gait reduces the first peak KAM through lateralising the centre of pressure in early stance and moving the knees to a more medial position [36,37] and toe-out gait reduces the second peak KAM through lateralising the centre of pressure in late stance [35,36]. Reduction of both peaks simultaneously has also been achieved in healthy individuals during stair ascent using a combination of toe-in gait and wider steps [32]; however this has not been replicated in people with medial KOA. Although several studies have shown that gait modifications can indeed reduce the KAM (first or second peak) in the short term (i.e.…”

Section: Contents Lists Available At Sciencedirectmentioning

confidence: 99%

“…In recent years there has been a focus on the use of gait modifications to reduce the KAM. Gait modifications that can reduce the KAM include walking more slowly [28], walking with increased trunk lean [29,30], increased medial thrust of the knee [30,31], increased step width [32][33][34] or modified foot progression angle [35][36][37][38]. Changes in foot progression angle (FPA), walking with toe-in or toe-out gait, are most commonly investigated.…”

Section: Contents Lists Available At Sciencedirectmentioning

confidence: 99%

Gait retraining using real-time feedback in patients with medial knee osteoarthritis: Feasibility and effects of a six-week gait training program

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Stair walking is a common motion in everyday life and requires more physical load and range of motion in the lower limb joints than walking on flat ground, resulting in higher energy consumption than ordinary walking. Stair descent has also been reported to have a higher fall risk than stair ascent [1][2] [3].…”

Section: Introductionmentioning

confidence: 99%

Gait Analysis in Adult people with Hip Retrotorsion

Oh¹

2019

IJIPHM

View full text Add to dashboard Cite

The purpose of this study was to conduct gait analysis of the hip joints of adults with retrotorsion when walking down stairs. Methods: Ten students with hip retrotorsion were selected from 230 healthy men and women. Results: The range of motion in the retrotorsion group in the sagittal and frontal planes was not significantly different in either joint (p>.05), but the affected side at the transverse plane had a significantly lower range of motion than the non-affected side (p<.05). There was no significant difference in either joint in the normal group in all planes (p>.05). Conclusion: During stair descent in adults with hip retrotorsion, the affected side showed greater internal rotation and a lower abduction angle than the nonaffected side. We expect these findings to help in preventing musculoskeletal disorders that may occur in daily life due to femoral torsion and to offer valuable information regarding walking.

show abstract

Effects of Toe-In and Wider Step Width in Stair Ascent with Different Knee Alignments

Cited by 23 publications

References 41 publications

The learning process of gait retraining using real-time feedback in patients with medial knee osteoarthritis

The learning process of gait retraining using real-time feedback in patients with medial knee osteoarthritis

Gait retraining using real-time feedback in patients with medial knee osteoarthritis: Feasibility and effects of a six-week gait training program

Gait Analysis in Adult people with Hip Retrotorsion

Contact Info

Product

Resources

About