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. 2023 Dec 19;24(1):984.
doi: 10.1186/s12891-023-07098-y.

The effectiveness of a 6-week biofeedback gait retraining programme in people with knee osteoarthritis: protocol for a randomised controlled trial

Yi Wan  1   2 , Polly McGuigan  3   4 , James Bilzon  3   4   5 , Logan Wade  3   4
Affiliations

The effectiveness of a 6-week biofeedback gait retraining programme in people with knee osteoarthritis: protocol for a randomised controlled trial

Yi Wan et al. BMC Musculoskelet Disord. .

Abstract

Background: Gait retraining is a common therapeutic intervention that can alter gait characteristics to reduce knee loading in knee osteoarthritis populations. It can be enhanced when combined with biofeedback that provides real-time information about the users' gait, either directly (i.e. knee moment feedback) or indirectly (i.e. gait pattern feedback). However, it is unknown which types of biofeedback are more effective at reducing knee loading, and also how the changes in gait affect pain during different activities of daily living. Therefore, this study aims to evaluate the acute (6 weeks of training) and chronic (1 month post training) effects of biofeedback based on personalised gait patterns to reduce knee loading and pain in people with knee osteoarthritis, as well as examine if more than one session of knee moment feedback is needed to optimise the gait patterns.

Methods: This is a parallel group, randomised controlled trial in a symptomatic knee osteoarthritis population in which participants will be randomised into either a knee moment biofeedback group (n = 20), a gait pattern biofeedback group (n = 20) or a control group (n = 10). Supervised training sessions will be carried out weekly for six continuous weeks, with real-time biofeedback provided using marker-based motion capture and an instrumented treadmill. Baseline, post-intervention and 1-month follow-up assessments will be performed to measure knee loading parameters, gait pattern parameters, muscle activation, knee pain and functional ability.

Discussion: This study will identify the optimal gait patterns for participants' gait retraining and compare the effectiveness of gait pattern biofeedback to a control group in reducing knee loading and index knee pain. Additionally, this study will explore how many sessions are needed to identify the optimal gait pattern with knee moment feedback. Results will be disseminated in future peer-reviewed journal articles, conference presentations and internet media to a wide audience of clinicians, physiotherapists, researchers and individuals with knee osteoarthritis.

Trial registration: This study was retrospectively registered under the International Standard Randomised Controlled Trial Number registry on 7th March 2023 (ISRCTN28045513).

Keywords: Biofeedback; Biomechanics; Gait retraining; Knee loading; Knee osteoarthritis; Sit-to-stand; Stair.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Trial flow chart
Fig. 2
Fig. 2
Schedule of training time and feedback time during gait retraining sessions from week 1 to week 6. The orange line represents treadmill walking time, which is identical for all three group. The grey line represents feedback time, which is identical for the two intervention groups
Fig. 3
Fig. 3
Example of real-time knee moment feedback (left) and gait pattern feedback (right). The light grey shaded area in each graph is the customised target for each parameter
See this image and copyright information in PMC

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