Real-Time Knee Adduction Moment Feedback for Gait Retraining Through Visual and Tactile Displays
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AbstractThe external knee adduction moment (KAM) measured during gait is an indicator of tibiofemoral joint osteoarthritis progression and various strategies have been proposed to lower it. Gait retraining has been shown to be an effective, noninvasive approach for lowering the KAM. We present a new gait retraining approach in which the KAM is fed back to subjects in real-time during ambulation. A study was conducted in which 16 healthy subjects learned to alter gait patterns to lower the KAM through visual or tactile (vibration) feedback. Participants converged on a comfortable gait in just a few minutes by using the feedback to iterate on various kinematic modifications. All subjects adopted altered gait patterns with lower KAM compared with normal ambulation (average reduction of 20.7%). Tactile and visual feedbacks were equally effective for real-time training, although subjects using tactile feedback took longer to converge on an acceptable gait. This study shows that real-time feedback of the KAM can greatly increase the effectiveness and efficiency of subject-specific gait retraining compared with conventional methods. © 2011 American Society of Mechanical Engineers.
CitationWheeler JW, Shull PB, Besier TF (2011) Real-Time Knee Adduction Moment Feedback for Gait Retraining Through Visual and Tactile Displays. J Biomech Eng 133: 041007. Available: http://dx.doi.org/10.1115/1.4003621.
SponsorsThe authors would like to thank Scott Delp and Mark Cutkoskyfor their input on the study. J. Wheeler was funded by SandiaNational Laboratories Doctoral Studies Program. P. Shull was partiallyfunded by the King Abdullah University of Science andTechnology.
CollectionsPublications Acknowledging KAUST Support
- Training multi-parameter gaits to reduce the knee adduction moment with data-driven models and haptic feedback.
- Authors: Shull PB, Lurie KL, Cutkosky MR, Besier TF
- Issue date: 2011 May 17
- Gait modification via verbal instruction and an active feedback system to reduce peak knee adduction moment.
- Authors: Dowling AV, Fisher DS, Andriacchi TP
- Issue date: 2010 Jul
- Subject-specific toe-in or toe-out gait modifications reduce the larger knee adduction moment peak more than a non-personalized approach.
- Authors: Uhlrich SD, Silder A, Beaupre GS, Shull PB, Delp SL
- Issue date: 2018 Jan 3
- Immediate and short-term effects of real-time knee adduction moment feedback on the peak and cumulative knee load during walking.
- Authors: Jackson B, Gordon KE, Chang AH
- Issue date: 2018 Jan
- Feasibility of a gait retraining strategy for reducing knee joint loading: increased trunk lean guided by real-time biofeedback.
- Authors: Hunt MA, Simic M, Hinman RS, Bennell KL, Wrigley TV
- Issue date: 2011 Mar 15