Long-Term Effectiveness of Walking Training in Patients With Knee Osteoarthritis
Trial ID or NCT#
Nearly one out of every two Americans will develop knee osteoarthritis by age 85. Over 20 million Americans, including nearly three million Veterans, currently have painful knee arthritis that limits their daily activity or recreation. The vast majority of those individuals will be prescribed anti-inflammatory drugs that provide some pain relief but do not slow the progression of the disease. Often people with knee arthritis are told they must live with the pain until they become appropriate candidates for knee replacement surgery, but that can require tolerating the pain and limiting function for many years. Because of other health issues, some individuals are never acceptable surgery candidates. What is desperately needed are better conservative approaches for treating these patients. Two such approaches will be tested and compared in this study.
Personalized Gait Training With Feedback to Reduce Knee Pain From Osteoarthritis
- - Diagnosed with isolated, medial compartment knee OA of at least six months duration - Kellgren-Lawrence grade of I, II, or III - Age greater than 18 years at the time of enrollment - Ability to give informed consent - Knee pain more than three days per week on average - Average knee pain in medial compartment between 3 and 9 on an 11-point Numerical Rating Scale, and greater than pain in other compartments - Ambulatory without aids - Able to walk for at least 25 consecutive minutes - Able to walk on treadmill safely at 0.7 m/s or faster - Able to reduce the prominent peak of the knee adduction moment by changing foot progression angle
- - Body mass index equal to or greater than 35 - Pregnancy - Plans for knee replacement within the next 12 months - Contraindications to MRI - Nerve or muscle disease associated with walking difficulty - Narcotic pain medication usage - History of rheumatoid arthritis or autoimmune disease - An episode of gout or pseudogout in the knee in the past year - History of neuropathic arthropathy, infectious disease, or other major systemic diseases - Current or recent past use (within two months) of oral corticosteroids - Cognitive impairments that would limit a subject's understanding - Expecting a significant change in activity level or weight within the next 12 months - Regularly participates in high impact activities such as running, soccer, basketball, etc. - Unable to perform the 3rd stage of the 4-stage balance test, which involves holding a tandem stance for 10 seconds The following criteria apply only to the affected osteoarthritic limb: - History of symptomatic arthritis in lower limb joints other than the knees that is more severe than knee arthritis - Replacement of any lower extremity joint - Lateral tibiofemoral joint space width less than medial - Recurrent giving way of the knee - Symptoms arising primarily from a meniscal or ligament pathology or other structure not directly related to osteoarthritis as identified by physical exam, health record, or MRI - Symptoms originating primarily from the patellofemoral joint - Avascular necrosis - Recent (within two months) knee injury or surgery - Planned use of hinged knee brace in next 12 months - Severe knee malalignment of more than 10 degrees from neutral - Intra-articular injection within the past 2 months or planned for the next 12 months
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Julie Kolesar, PhD