August 2015

Muscle force changes vary after gait modification to reduce knee moment

In the moment: Knee OA

By Jordana Bieze Foster

A single gait modification to reduce knee adduction moment in patients with knee osteoarthritis (OA) is associated with muscle force pattern changes that vary from one patient to another, according to research from Shanghai, China.

Investigators from Shanghai Jiao Tong University analyzed 10 individuals with self-reported knee pain and radiographic medial compartment knee OA as they walked using their customary gait and a toe-in gait modification. They then used muscle-actuated dynamic simulations to determine muscle force patterns for each gait condition.

Foot progression angle during the toe-in gait averaged 7° less than during customary gait, and the kinematic change was accompanied by a 20% mean decrease in knee adduction moment. However, although the researchers observed changes in muscle force patterns associated with the gait modification within individuals, these muscle force pattern changes were not consistent across the patient population.

The findings, which were epublished in July by the Journal of Biomechanics, suggest clinicians may want to consider muscle forces in addition to kinematics when implementing gait retraining in patients with knee OA.


Shull PB, Huang Y, Schlotman T, Reinbolt JA. Muscle force modification strategies are not consistent for gait retraining to reduce the knee adduction moment in individuals with knee osteoarthritis. J Biomech 2015 Jul 17. [Epub ahead of print]

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