Gait retraining eases knee osteoarthritis pain as effectively as medication, can delay knee surgery

Editor's Note

A simple adjustment to walking style can relieve osteoarthritis pain as well as medication and may delay the need for knee surgery, according to a year-long clinical trial published in The Lancet Rheumatology and covered by The Independent on August 18.

As detailed in the article, University of Utah researchers studied 68 patients with mild-to-moderate medial knee osteoarthritis, the form of the disease that most often bears extra weight. Participants first underwent MRI scans and motion analysis to determine whether turning the foot inward or outward, and by how many degrees, would best reduce knee loading. Those who showed no potential benefit from gait changes were excluded.

According to the study, participants were randomly assigned to either an intervention group, which received a personalized foot angle adjustment, or a placebo group. The intervention group trained with real-time feedback from a wearable sensor, helping them maintain the prescribed gait. Both groups completed 6 weekly sessions, after which participants in the intervention group were encouraged to practice their new walking pattern for at least 20 minutes daily.

A year later, the outlet reports, patients in the gait retraining group reported less knee pain and showed reduced cartilage degradation on MRI compared with controls. Pain relief was comparable to that achieved with common medications, ranging between the effects of ibuprofen and narcotics. Importantly, MRI scans indicated slower deterioration of cartilage health markers in those who adopted the gait modifications.

The researchers highlighted the individualized approach was key to effectiveness, as the optimal adjustment varied by patient. Adherence to the intervention is feasible over the long term, potentially offering a non-pharmacological option for patients who face decades of pain management before joint replacement becomes appropriate. The article concludes that gait retraining could fill a significant treatment gap for osteoarthritis. Scientists are now working on ways to streamline delivery, including the use of mobile sensors, smartphone video, and smart footwear to personalize and monitor gait modifications in clinical practice.