Placebo gait retraining for use in knee osteoarthritis clinical trials does not change surrogate knee load measures: A randomized pilot study

Introduction: Gait retraining is a novel management strategy which has shown ability to reduce pain and the peak knee adduction moment (KAM) (a surrogate measure of medial load) in people with osteoarthritis. However, no published study compared gait placebo change does not affect KAM). Therefore, it unknown whether improvement due KAM reduction. Our primary aim was determine joint loading outcomes during placebo, toe-in, toe-out baseline. Secondary aims were evaluate effects three conditions on other lower limb trunk biomechanical outcomes. Methods: We conducted randomised repeated measures pilot following CONSORT extension for feasibility studies. Three-dimensional analysis performed five healthy female participants known pathology baseline gait, retraining. The involved walking more upright trunk. hypothesised altering sagittal plane position would impact load. Knee averaged over four-six trials included: early late stance KAM, impulse, flexion (KFM). Means 95% confidence intervals (CI) obtained using linear mixed models. Results: Mean CI (Nm/(BW*Ht)%) were: baseline: 4.78 (3.95, 5.59), placebo: 4.76 (3.93, 5.58); 3.74 (2.20, 5.29), 3.86 (2.31, 5.40). There difference KFM or impulse between placebo. Toe-in reduced from Placebo mean angle conditions. increased foot progression baseline, respectively. Discussion: load while achieved From perspective, we have developed promising condition clinical trials. Future studies may consider replicating this larger sample, group osteoarthritis, assessing long-term symptomatic effects, evaluating credibility participant perspective. Impact application field: can be used high quality controlled investigating effect symptoms Placebo-controlled will ascertain symptom reduction others factors such walking, clinician-patient interaction. This useful therapists implementing and/or programs osteoarthritis guide achieving important relative program aspects. authors conflict interest relevant abstract.