Effectiveness of gait retraining interventions in individuals with hip or knee osteoarthritis : A systematic review and meta-analysis

Journal article

Rynne, Rebecca, Le Tong, Gia, Cheung, Roy and Constantinou, Maria. (2022). Effectiveness of gait retraining interventions in individuals with hip or knee osteoarthritis : A systematic review and meta-analysis. Gait and Posture. 95, pp. 164-175. https://doi.org/10.1016/j.gaitpost.2022.04.013

Publication dates
Authors	Rynne, Rebecca, Le Tong, Gia, Cheung, Roy and Constantinou, Maria
Abstract	Background: Osteoarthritis is a chronic synovial joint disease leading to pain, stiffness, and gait dysfunction, resulting in a significant health and economic burden. Gait retraining strategies and tools are used to address biomechanical gait dysfunction and symptoms in individuals with osteoarthritis. However, there is limited evidence relating to their effectiveness. Question: Do gait retraining strategies and tools improve gait biomechanics and symptoms in individuals with hip or knee osteoarthritis compared to control or alternate intervention? Methods: Seven databases were searched using key words relating to osteoarthritis, gait retraining, and biomechanics. A best evidence synthesis was conducted on included studies. Where available, a meta-analysis was performed, and the standardised mean difference (SMD) and 95% confidence internals (CI) were reported. Results: Eighteen studies were included. One study investigated gait retraining in participants with hip osteoarthritis and demonstrated limited evidence for improving gait biomechanics. Seventeen studies on knee osteoarthritis were included in the best evidence synthesis with six included in the meta-analysis. Gait retraining strategies which incorporated a real-time biofeedback tool, appear to have strong evidence for effectively modifying walking biomechanics. Moderate evidence was identified to support kinesiology taping improving pain scores. The meta-analysis pooled effect demonstrated significant improvements for knee adduction moment [SMD, −1.10; 95% CI. −1.85, −0.35] and the Western Ontario and McMaster Osteoarthritis Index in favour of gait retraining than a control intervention [SMD, −0.86; 95% CI. −1.33, −0.39]. All other interventions demonstrated evidence that was conflicting, limited, or not in favour of gait retraining. Conclusion: Gait retraining may be beneficial for improving biomechanics and symptoms in knee osteoarthritis, however due to the high heterogeneity and limited studies in the analysis, further research is required. Further high quality randomised controlled trials for knee and especially hip osteoarthritis investigating the effects of gait retraining on biomechanics and symptoms are required.
Keywords	Walking; Biomechanics; Speed; Joint moments; Rehabilitation
Year	01 Jan 2022
Journal	Gait and Posture
Journal citation	95, pp. 164-175
Publisher	Elsevier Ltd.
ISSN	1879-2219
Digital Object Identifier (DOI)	https://doi.org/10.1016/j.gaitpost.2022.04.013
PubMed ID	35500366
Web address (URL)	https://www.sciencedirect.com/science/article/pii/S0966636222001072
Open access	Published as non-open access
Research or scholarly	Research
Page range	164-175
Publisher's version	License All rights reserved File Access Level Controlled
Output status	Published
Print	29 Apr 2022
Publication process dates
Accepted	15 Apr 2022
Deposited	05 Jan 2023
Additional information	Copyright © 2022 Elsevier B.V. All rights reserved.
Place of publication	United Kingdom

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