Effect of exercise and gait retraining on knee adduction moment in people with knee osteoarthritis

Abstract

The knee adduction moment represents the medial knee joint load, and greater value is associated with higher load. In people with knee osteoarthritis, it is important to apply proper treatment with the least side effects to reduce knee adduction moment and, consequently, reduce medial knee joint load. This reduction may slow the progression of knee osteoarthritis. The research team performed a literature search of electronic databases. The search keywords were as follows: knee osteoarthritis, knee adduction moment, exercise program, exercise therapy, gait retraining, gait modification and knee joint loading. In total, 12 studies were selected, according to the selection criteria. Findings from previous studies illustrated that exercise and gait retraining programs could alter knee adduction moment in people with knee osteoarthritis. These treatments are noninvasive and nonpharmacological which so far have no or few side effects, as well as being low cost. The results of this review revealed that gait retraining programs were helpful in reducing the knee adduction moment. In contrast, not all the exercise programs were beneficial in reducing knee adduction moment. Future studies are needed to indicate best clinical exercise and gait retraining programs, which are most effective in reducing knee adduction moment in people with knee osteoarthritis.

Gait- and postural-alignment-related prognostic factors for hip and knee osteoarthritis: Toward the prevention of osteoarthritis progression

“…To prevent the progression of knee OA, it is essential to reduce excessive or abnormal gait-related mechanical stresses on the knee joint, indicated by increased KAM. Several interventions, such as strengthening exercises and gait modifications using medial thrust, trunk lean, and realtime feedback, have been reported to reduce KAM 41) . However, it is not yet clear whether the sustained long-term effects of these interventions and improved knee joint loading may prevent disease progression.…”

No effects of a 12-week supervised exercise therapy program on gait in patients with mild to moderate osteoarthritis: a secondary analysis of a randomized trial

“…This assumption is true even when looking into existing studies on targeted gait interventions. A recent review by Khalaj et al [25] suggested specific gait retraining programs to be advantageous to reduce knee adduction moment in patients with knee OA, whereas the efficacy of more generalized exercise programs was found to be inconclusive. In contrast, the findings reported in the systematic review by Simic et al [26] were inconclusive regarding the efficacy of targeted gait modification strategies to alter knee joint loads.…”

Biomechanical dysfunction in patients with primary osteoarthritis of the knee: the role of physical therapy

“…In the initial stages of synovitis, the main aim of physical rehabilitation is to strengthen the periarticular muscles, since a strong muscle mass provides a dampening function, ensuring a smooth transfer of translational forces to the articular surface, protecting the joint from twisting and hypermobility. Physical activity improves microcirculation in the articular structures, and dynamic exercises improve the circulation of synovial fluid in the joint [9].…”