Does Gait Retraining Have the Potential to Reduce Medial Compartmental Loading in Individuals With Knee Osteoarthritis While Not Adversely Affecting the Other Lower Limb Joints? A Systematic Review.
Jake Bowd, Paul Biggs, Cathy Holt and 1 others
PMID 33543053WHAT IT FOUND
Gait retraining reduced knee loading in some studies, but evidence for safety at the hip and ankle is missing or conflicting.
Most data came from healthy people, not patients with knee osteoarthritis, so these findings cannot yet guide clinical practice.
Key findings
01Strategies like trunk lean, hip internal rotation, and medial thrust showed medium to large effect sizes in reducing the first peak external knee adduction moment.
02The review could not confirm whether gait retraining causes adverse effects on adjacent joints due to a lack of evidence and conflicting data regarding the hip and ankle.
03Six of the eleven included studies assessed healthy participants without osteoarthritis, limiting the generalizability of findings to patients.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Only 11 studies were included, and they varied widely in the biomechanical variables reported, preventing a meta-analysis. Most studies had small sample sizes (8-40 participants) and used a single-visit design, assessing immediate effects rather than long-term adaptation. Six of the eleven studies used healthy participants without osteoarthritis, so the findings may not apply to patients with medial knee OA. The included studies lacked external validity, meaning the controlled laboratory conditions may not reflect real-world walking. There was insufficient data on patient-reported outcomes like pain and function to determine clinical significance.
The easy way to misread this
Do not assume that gait retraining is safe for the hip and ankle. The review explicitly states that adverse effects on adjacent joints cannot be ruled out because most studies did not report enough biomechanical data for these areas, and the available data was conflicting.