Review Article
Year: 2022 | Month: March | Volume: 12 | Issue: 3 | Pages: 402-408
DOI: https://doi.org/10.52403/ijhsr.20220353
Effects of Gait Modification Strategies on Loading of Knee and Spine in Individuals with Knee OA: A Narrative Review
Urmi Bhatt1, Yagna Shukla2
1MPT (Musculoskeletal Conditions), PhD Scholar, Gujarat University and Assistant Professor, C. U. Shah Physiotherapy College, Surendranagar, Gujarat, India
2MPT, PhD (Physiotherapy), Senior Lecturer, Government Physiotherapy College, Ahmedabad, Gujarat, India.
Corresponding Author: Urmi Bhatt
ABSTRACT
Background and Objectives: Gait is an automatic function in healthy individuals that demands minimal or no attention to maintain a steady pattern. Alterations in gait are associated with multiple factors, yet strongest association is seen with lower limb joint arthritis, osteoarthritis of knee being the commonest. Alterations in gait of OA knee individuals are compensatory strategies to reduce medial knee joint loading and pain. Till date, numerous compensatory gait strategies to alter external knee adduction moment have been identified and reported in the literature. The objectives of current narrative review are to report effects of gait modifications on loading of knee and spine in individuals with knee OA.
Methods: A literature search for current study was performed in electronic databases of PubMed and Google scholar from 1990 to 2019 with “Gait”, “Biomechanics” and “OA knee” as key words. 584 articles were assessed, articles assessing gait or fall risk in OA knee following ACL/meniscal injury, total knee replacement or any type of knee surgery, medications or any type of therapeutic interventions were eliminated.
Findings: Increased hip abduction and lateral trunk leaning during swing phase, contralateral pelvic drop, increased anterior tilting of pelvis, increased hip, knee and ankle flexion angles in sagittal plane, increased step width, increased hip internal rotation, weight transfer to the medial foot are common strategies adopted by OA knee individuals to reduce Knee Adduction Moment (KAM). A few studies have reported adverse loading of spine, hip joints and contralateral knee because of gait adaptations seen in individuals with knee OA.
Conclusion: Findings of current review suggests that altered trunk and pelvis kinematics may predispose OA knee individuals to development of degenerative low back pain, which should be given attention while planning rehabilitation strategies for OA knee individuals.
Key words: OA knee, Gait, Knee adduction moment, Trunk lean.