The Effect of Physical Activity on Knee Osteoarthritis, Pain and Gait

Official title

The Effect of Retro Walking on Pain and Gait Biomechanics Using Non-linear Analysis in People With Knee Osteoarthritis

Overview

Knee osteoarthritis, a chronic musculoskeletal disease, is the most prevalent type of osteoarthritis and the leading cause of disability and major healthcare costs worldwide. The pathogenesis of the disease is not fully understood and there are few non-invasive disease-modifying therapies available to patients. Therefore, there is a critical need to enhance therapeutic interventions, which requires improvement of our understanding of knee osteoarthritis pathogenesis. Increasing evidence suggests that physical activity and exercise training are cost-effective and widely available interventions for the treatment of knee osteoarthritis, however, consideration of type of physical activity and optimal exercise modality are needed to reduce pain, improve gait, knee joint function, stiffness, and muscle weakness in individuals with knee osteoarthritis. The aim of this pilot clinical trial is to compare individuals with knee osteoarthritis who have not exercised with individuals that have performed retro walking exercise chosen from the systematic review and survey we have conducted previously to reduce pain and improve gait. Non-linear analyses will be performed to determine the effects of exercise intervention on gait biomechanics and stability of movement in these patients. These findings may form a basis for recommendations of exercise/physical activity interventions for the benefits of patients with knee osteoarthritis including pain reduction, mobility improvement and gait modification.

Interventions

• Other Retro walking (backwards walking) on a treadmill
  Prior to the intervention participants will be made familiar with retro walking on the treadmill. The exercise will consist of a forward walking for 5min on the treadmill for warm-up followed by retro walking for 10min and a cool-down for 5min. Participants will be instructed to increase their retro walking time up to 30min if the pain sensation continuously was reduced (pain scores \< 3 numerical rating scale). The comfortable speed of the retro walking will be determined by the participant un

Primary outcome measures

• Knee function and associated frequency and severity of pain [Time frame: Baseline or Day 1 and end of study at 6 weeks]

Secondary outcome measures (12)

• Pain intensity [Time frame: Baseline or Day 1 up to 6 weeks]
• The gait biomechanics - change from baseline in spatiotemporal parameter walking speed at 6 weeks [Time frame: Baseline or Day 1 and end of study at 6 weeks]
• The gait biomechanics - change from baseline in spatiotemporal parameter cadence at 6 weeks [Time frame: Baseline or Day 1 and end of study at 6 weeks]
• The gait biomechanics - change from baseline in spatiotemporal parameter stride/step length at 6 weeks [Time frame: Baseline or Day 1 and end of study at 6 weeks]
• The gait biomechanics - change from baseline in spatiotemporal parameter swing/stance phases at 6 weeks [Time frame: Baseline or Day 1 and end of study at 6 weeks]
• The gait biomechanics - change from baseline in spatiotemporal parameter double support time at 6 weeks [Time frame: Baseline or Day 1 and end of study at 6 weeks]
• The gait biomechanics - change from baseline in kinetic parameter knee adduction moment (KAM) at 6 weeks [Time frame: Baseline or Day 1 and end of study at 6 weeks]
• The gait biomechanics - change from baseline in kinetic parameter knee flexion/extension moment at 6 weeks [Time frame: Baseline or Day 1 and end of study at 6 weeks]
• The gait biomechanics - change from baseline in kinetic parameter vertical ground reaction force (vGRF) at 6 weeks [Time frame: Baseline or Day 1 and end of study at 6 weeks]
• The gait biomechanics - change from baseline in kinetic parameter joint contact force (JCF) at 6 weeks [Time frame: Baseline or Day 1 and end of study at 6 weeks]
• The gait biomechanics - change from baseline in kinematic parameter knee flexion angle at 6 weeks [Time frame: Baseline or Day 1 and end of study at 6 weeks]
• The gait biomechanics - change from baseline in kinematic parameter Range of Motion (ROM) at 6 weeks [Time frame: Baseline or Day 1 and end of study at 6 weeks]

Eligibility criteria

Inclusion criteria

• Male and female
• Any ethnicity
• Adults over 18 years old
• Meet the UK guidelines for physical activity supported by NICE (National Institute for Health and Care Excellence) and NHS (able to exercise if it is safe with regular breaks)
• Otherwise, adults with clinically diagnosed knee osteoarthritis according to NICE criteria or confirmed by a healthcare professional able and willing to participate and provide written informed consent

Exclusion criteria

• Any musculoskeletal injury
• Any conditions known to affects gait (e.g. Parkinson's disease or stroke)
• Any surgical intervention in the previous 12 months on lower limbs
• Surgical replacement of hip or knee joints
• BMI (body mass index) over 35
• Athletes or take part in significant recreational activity
• Takes any medication known to affect the gait and ability to walk
• Received an intra-articular injection in the last 3 months
• Have been told by medical professionals that they should not take part in any intensity exercise/physical activity

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Open label

Primary purpose

Prevention

Study locations

Center list to be confirmed — check the primary protocol.

Identifiers

NCT: NCT07649863 · 356992

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗