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BACKGROUND: The justification of the treatment techniques for patients with gonarthrosis requires the use of modern methods for assessing walking stereotypes. AIM: This study aimed to evaluate the biomechanical and podometric gait parameters of patients with gonarthrosis using the C-Mill multifunctional complex with biofeedback. MATERIALS AND METHODS: The study included 55 patients who were divided into the following groups: main group (n=35) of patients who had gait disturbances, diagnosed with stage III–IV primary gonarthrosis with varus deformation of the limb axis according to ICD-10, and underwent total knee replacement and control group (n=20) of patients diagnosed with stage I primary gonarthrosis. The average age of patients was 58.7 years in the main group and 47.5 years in the control group. RESULTS: In the main group, the decrease in average walking speed was accompanied by decreases in stride length and step frequency (р 0.05). In the stance phase, which is characterized by the contact of the foot of the affected and contralateral lower extremities with the platform surface, the durations of the double stance phase of both extremities in the main group were longer than those in the control group (p 0.05), indicating gait asymmetry and redistribution of excess load on the contralateral lower extremity, which is clinically manifested by lameness. In the main group, gait was characterized by a decrease in voluntary speed, step frequency, and gait pattern changes in various planes, confirming severe clinical and functional disorders in the lower limbs. CONCLUSION: The study of the walking stereotype in patients using the C-Mill multifunctional complex with biofeedback can be used to substantiate treatment techniques, followed by drawing up an individual medical rehabilitation plan to restore lower limb functions in the postoperative period, fully monitor treatment dynamics, prevent falls, and improve the quality of life of patients.
BACKGROUND: The justification of the treatment techniques for patients with gonarthrosis requires the use of modern methods for assessing walking stereotypes. AIM: This study aimed to evaluate the biomechanical and podometric gait parameters of patients with gonarthrosis using the C-Mill multifunctional complex with biofeedback. MATERIALS AND METHODS: The study included 55 patients who were divided into the following groups: main group (n=35) of patients who had gait disturbances, diagnosed with stage III–IV primary gonarthrosis with varus deformation of the limb axis according to ICD-10, and underwent total knee replacement and control group (n=20) of patients diagnosed with stage I primary gonarthrosis. The average age of patients was 58.7 years in the main group and 47.5 years in the control group. RESULTS: In the main group, the decrease in average walking speed was accompanied by decreases in stride length and step frequency (р 0.05). In the stance phase, which is characterized by the contact of the foot of the affected and contralateral lower extremities with the platform surface, the durations of the double stance phase of both extremities in the main group were longer than those in the control group (p 0.05), indicating gait asymmetry and redistribution of excess load on the contralateral lower extremity, which is clinically manifested by lameness. In the main group, gait was characterized by a decrease in voluntary speed, step frequency, and gait pattern changes in various planes, confirming severe clinical and functional disorders in the lower limbs. CONCLUSION: The study of the walking stereotype in patients using the C-Mill multifunctional complex with biofeedback can be used to substantiate treatment techniques, followed by drawing up an individual medical rehabilitation plan to restore lower limb functions in the postoperative period, fully monitor treatment dynamics, prevent falls, and improve the quality of life of patients.
Exercise therapy can be part of a conservative treatment plan for knee osteoarthritis. Knee adduction moments (KAMs) are thought to be reduced with exercise therapy. A large study looked at exercise therapy's effect on KAM and other physical factors in persons with knee osteoarthritis. Methods: Searches were performed on the following electronic databases: MEDLINE, Google Scholar, Cochrane Central, EMBASE, and OpenGrey. Study participants with knee osteoarthritis undergoing structured exercise therapy were randomized controlled trials. For every study, we conducted independent analyses to extract data and analyze the bias risks. We calculated the mean differences and 95% confidence intervals for each outcome. Results: In the three studies that involved 233 participants, there were no significant differences in KAMs between intervention and control groups. Two of the studies observed improvements in physical function after exercise therapy and one of them demonstrated significant reductions in pain. All three trials favor the intervention group in terms of muscle strength and torque. Conclusions: A change in knee adduction time was not associated with the therapeutic benefits of exercise therapy. Exercise therapy for knee osteoarthritis may not be effective if there is no momentary adduction. Dynamic joint loading may result from a shift in neuromuscular control after exercise therapy
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