Cargando…
Effects of neuromuscular gait modification strategies on indicators of knee joint load in people with medial knee osteoarthritis: A systematic review and meta-analysis
OBJECTIVES: This systematic review aimed to determine the effects of neuromuscular gait modification strategies on indicators of medial knee joint load in people with medial knee osteoarthritis. METHODS: Databases (Embase, MEDLINE, Cochrane Central, CINAHL and PubMed) were searched for studies of ga...
Autores principales: | , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9491578/ https://www.ncbi.nlm.nih.gov/pubmed/36129904 http://dx.doi.org/10.1371/journal.pone.0274874 |
_version_ | 1784793305184206848 |
---|---|
author | Silva, M. Denika C. Perriman, Diana M. Fearon, Angela M. Tait, Daniel Spencer, Trevor J. Walton-Sonda, Dianne Simic, Milena Hinman, Rana S. Bennell, Kim L. Scarvell, Jennie M. |
author_facet | Silva, M. Denika C. Perriman, Diana M. Fearon, Angela M. Tait, Daniel Spencer, Trevor J. Walton-Sonda, Dianne Simic, Milena Hinman, Rana S. Bennell, Kim L. Scarvell, Jennie M. |
author_sort | Silva, M. Denika C. |
collection | PubMed |
description | OBJECTIVES: This systematic review aimed to determine the effects of neuromuscular gait modification strategies on indicators of medial knee joint load in people with medial knee osteoarthritis. METHODS: Databases (Embase, MEDLINE, Cochrane Central, CINAHL and PubMed) were searched for studies of gait interventions aimed at reducing medial knee joint load indicators for adults with medial knee osteoarthritis. Studies evaluating gait aids or orthoses were excluded. Hedges’ g effect sizes (ES) before and after gait retraining were estimated for inclusion in quality-adjusted meta-analysis models. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS: Seventeen studies (k = 17; n = 362) included two randomised placebo-controlled trials (RCT), four randomised cross-over trials, two case studies and nine cohort studies. The studies consisted of gait strategies of ipsilateral trunk lean (k = 4, n = 73), toe-out (k = 6, n = 104), toe-in (k = 5, n = 89), medial knee thrust (k = 3, n = 61), medial weight transfer at the foot (k = 1, n = 10), wider steps (k = 1, n = 15) and external knee adduction moment (KAM) biofeedback (k = 3, n = 84). Meta-analyses found that ipsilateral trunk lean reduced early stance peak KAM (KAM1, ES and 95%CI: -0.67, -1.01 to -0.33) with a dose-response effect and reduced KAM impulse (-0.37, -0.70 to -0.04) immediately after single-session training. Toe-out had no effect on KAM1 but reduced late stance peak KAM (KAM2; -0.42, -0.73 to -0.11) immediately post-training for single-session, 10 or 16-week interventions. Toe-in reduced KAM1 (-0.51, -0.81 to -0.20) and increased KAM2 (0.44, 0.04 to 0.85) immediately post-training for single-session to 6-week interventions. Visual, verbal and haptic feedback was used to train gait strategies. Certainty of evidence was very-low to low according to the GRADE approach. CONCLUSION: Very-low to low certainty of evidence suggests that there is a potential that ipsilateral trunk lean, toe-out, and toe-in to be clinically helpful to reduce indicators of medial knee joint load. There is yet little evidence for interventions over several weeks. |
format | Online Article Text |
id | pubmed-9491578 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-94915782022-09-22 Effects of neuromuscular gait modification strategies on indicators of knee joint load in people with medial knee osteoarthritis: A systematic review and meta-analysis Silva, M. Denika C. Perriman, Diana M. Fearon, Angela M. Tait, Daniel Spencer, Trevor J. Walton-Sonda, Dianne Simic, Milena Hinman, Rana S. Bennell, Kim L. Scarvell, Jennie M. PLoS One Research Article OBJECTIVES: This systematic review aimed to determine the effects of neuromuscular gait modification strategies on indicators of medial knee joint load in people with medial knee osteoarthritis. METHODS: Databases (Embase, MEDLINE, Cochrane Central, CINAHL and PubMed) were searched for studies of gait interventions aimed at reducing medial knee joint load indicators for adults with medial knee osteoarthritis. Studies evaluating gait aids or orthoses were excluded. Hedges’ g effect sizes (ES) before and after gait retraining were estimated for inclusion in quality-adjusted meta-analysis models. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS: Seventeen studies (k = 17; n = 362) included two randomised placebo-controlled trials (RCT), four randomised cross-over trials, two case studies and nine cohort studies. The studies consisted of gait strategies of ipsilateral trunk lean (k = 4, n = 73), toe-out (k = 6, n = 104), toe-in (k = 5, n = 89), medial knee thrust (k = 3, n = 61), medial weight transfer at the foot (k = 1, n = 10), wider steps (k = 1, n = 15) and external knee adduction moment (KAM) biofeedback (k = 3, n = 84). Meta-analyses found that ipsilateral trunk lean reduced early stance peak KAM (KAM1, ES and 95%CI: -0.67, -1.01 to -0.33) with a dose-response effect and reduced KAM impulse (-0.37, -0.70 to -0.04) immediately after single-session training. Toe-out had no effect on KAM1 but reduced late stance peak KAM (KAM2; -0.42, -0.73 to -0.11) immediately post-training for single-session, 10 or 16-week interventions. Toe-in reduced KAM1 (-0.51, -0.81 to -0.20) and increased KAM2 (0.44, 0.04 to 0.85) immediately post-training for single-session to 6-week interventions. Visual, verbal and haptic feedback was used to train gait strategies. Certainty of evidence was very-low to low according to the GRADE approach. CONCLUSION: Very-low to low certainty of evidence suggests that there is a potential that ipsilateral trunk lean, toe-out, and toe-in to be clinically helpful to reduce indicators of medial knee joint load. There is yet little evidence for interventions over several weeks. Public Library of Science 2022-09-21 /pmc/articles/PMC9491578/ /pubmed/36129904 http://dx.doi.org/10.1371/journal.pone.0274874 Text en © 2022 Silva et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Silva, M. Denika C. Perriman, Diana M. Fearon, Angela M. Tait, Daniel Spencer, Trevor J. Walton-Sonda, Dianne Simic, Milena Hinman, Rana S. Bennell, Kim L. Scarvell, Jennie M. Effects of neuromuscular gait modification strategies on indicators of knee joint load in people with medial knee osteoarthritis: A systematic review and meta-analysis |
title | Effects of neuromuscular gait modification strategies on indicators of knee joint load in people with medial knee osteoarthritis: A systematic review and meta-analysis |
title_full | Effects of neuromuscular gait modification strategies on indicators of knee joint load in people with medial knee osteoarthritis: A systematic review and meta-analysis |
title_fullStr | Effects of neuromuscular gait modification strategies on indicators of knee joint load in people with medial knee osteoarthritis: A systematic review and meta-analysis |
title_full_unstemmed | Effects of neuromuscular gait modification strategies on indicators of knee joint load in people with medial knee osteoarthritis: A systematic review and meta-analysis |
title_short | Effects of neuromuscular gait modification strategies on indicators of knee joint load in people with medial knee osteoarthritis: A systematic review and meta-analysis |
title_sort | effects of neuromuscular gait modification strategies on indicators of knee joint load in people with medial knee osteoarthritis: a systematic review and meta-analysis |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9491578/ https://www.ncbi.nlm.nih.gov/pubmed/36129904 http://dx.doi.org/10.1371/journal.pone.0274874 |
work_keys_str_mv | AT silvamdenikac effectsofneuromusculargaitmodificationstrategiesonindicatorsofkneejointloadinpeoplewithmedialkneeosteoarthritisasystematicreviewandmetaanalysis AT perrimandianam effectsofneuromusculargaitmodificationstrategiesonindicatorsofkneejointloadinpeoplewithmedialkneeosteoarthritisasystematicreviewandmetaanalysis AT fearonangelam effectsofneuromusculargaitmodificationstrategiesonindicatorsofkneejointloadinpeoplewithmedialkneeosteoarthritisasystematicreviewandmetaanalysis AT taitdaniel effectsofneuromusculargaitmodificationstrategiesonindicatorsofkneejointloadinpeoplewithmedialkneeosteoarthritisasystematicreviewandmetaanalysis AT spencertrevorj effectsofneuromusculargaitmodificationstrategiesonindicatorsofkneejointloadinpeoplewithmedialkneeosteoarthritisasystematicreviewandmetaanalysis AT waltonsondadianne effectsofneuromusculargaitmodificationstrategiesonindicatorsofkneejointloadinpeoplewithmedialkneeosteoarthritisasystematicreviewandmetaanalysis AT simicmilena effectsofneuromusculargaitmodificationstrategiesonindicatorsofkneejointloadinpeoplewithmedialkneeosteoarthritisasystematicreviewandmetaanalysis AT hinmanranas effectsofneuromusculargaitmodificationstrategiesonindicatorsofkneejointloadinpeoplewithmedialkneeosteoarthritisasystematicreviewandmetaanalysis AT bennellkiml effectsofneuromusculargaitmodificationstrategiesonindicatorsofkneejointloadinpeoplewithmedialkneeosteoarthritisasystematicreviewandmetaanalysis AT scarvelljenniem effectsofneuromusculargaitmodificationstrategiesonindicatorsofkneejointloadinpeoplewithmedialkneeosteoarthritisasystematicreviewandmetaanalysis |