Six-week gait retraining program reduces knee adduction moment, reduces pain, and improves function for individuals with medial compartment knee osteoarthritis

This study examined the influence of a 6-week gait retraining program on the knee adduction moment (KAM) and knee pain and function. Ten subjects with medial compartment knee osteoarthritis and self-reported knee pain participated in weekly gait retraining sessions over 6 weeks. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores and a 10-point visual-analog pain scale score were measured at baseline, post-training (end of 6 weeks), and 1 month after training ended. Gait retraining reduced the first peak KAM by 20% (p<0.01) post-training as a result of a 7 degrees decrease in foot progression angle (i.e., increased internal foot rotation), compared to baseline (p<0.01). WOMAC pain and function scores were improved at post-training by 29% and 32%, respectively (p<0.05) and visual-analog pain scale scores improved by two points (p<0.05). Changes in WOMAC pain and function were approximately 75% larger than the expected placebo effect (p<0.05). Changes in KAM, foot progression angle, WOMAC pain and function, and visual-analog pain score were retained 1 month after the end of the 6-week training period (p<0.05). These results show that a 6-week gait retraining program can reduce the KAM and improve symptoms for individuals with medial compartment knee osteoarthritis and knee pain. (c) 2013 Orthopaedic Research Society Published by Wiley Periodicals, Inc. J Orthop Res 31:10201025, 2013