Real-Time Knee Adduction Moment Feedback for Gait Retraining Through Visual and Tactile Displays

Wheeler, Jason W.; Shull, Pete B.; Besier, Thor F.

Real-Time Knee Adduction Moment Feedback for Gait Retraining Through Visual and Tactile Displays

Type

Article

Authors

Wheeler, Jason W.
Shull, Pete B.
Besier, Thor F.

Online Publication Date

2011-03-15

Print Publication Date

2011-04-01

Date

2011-03-15

Abstract

The 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.

Citation

Wheeler 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.

Acknowledgements

The 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.