Osteoarthritis, a chronic and degenerative condition affecting joints, is particularly prevalent among individuals aged 40 and older. While it can impact any joint, the knees, hands, and hips are the most commonly affected areas. As there is currently no cure for osteoarthritis, management focuses on maintaining physical activity, healthy weight, and pain relief through medication.
A groundbreaking study has now emerged, suggesting that altering one’s walking style may provide relief from knee osteoarthritis pain and slow its progression. This research indicates that a simple change in how we walk can be as effective as standard medications used to treat the condition.
The Centers for Disease Control and Prevention (CDC) highlights osteoarthritis as the most common form of arthritis, affecting approximately 33 million adults in the United States alone. The likelihood of developing osteoarthritis increases significantly with age, with nearly 40% of individuals over 70 worldwide experiencing this debilitating condition. Despite various treatments available to alleviate symptoms, none can cure osteoarthritis.
To manage and potentially delay the onset of this condition, the CDC recommends several strategies. These include remaining physically active as one ages, ensuring a healthy weight, avoiding joint injuries, utilizing either over-the-counter or prescription medications, and employing assistive devices like crutches or walking sticks if necessary.
Conducted by researchers from the University of Utah, New York University, and Stanford University, the recent study published in The Lancet Rheumatology focuses on gait retraining as a means to alleviate knee osteoarthritis symptoms. The study finds that shifting the angle of the foot while walking can be effective in managing knee pain associated with osteoarthritis.
Dr. David Kruse, a primary care sports medicine physician at Cedars-Sinai Orthopaedics, commented on the study’s findings, expressing that the results are quite encouraging. Kruse noted that the research successfully demonstrated favorable outcomes through a personalized intervention aimed at optimizing joint unloading. He highlighted the significance of identifying an intervention that not only improves pain management but also helps to decelerate the progression of osteoarthritis.
Co-lead author Dr. Valentina Mazzoli, who is an assistant professor in the Department of Radiology at NYU Grossman School of Medicine, explained how the study indicates that altering foot angles while walking can yield substantial pain relief in individuals with knee osteoarthritis. Mazzoli affirmed that the pain improvement noted was comparable in significance to that typically achieved with pain medications, yet without the associated pharmacological side effects. Thus, gait retraining presents a promising alternative treatment for individuals in the early stages of knee osteoarthritis.
The study involved participants aged 18 years and older, all diagnosed with early-stage medial compartment knee osteoarthritis. These participants had radiologist-graded levels of 1 to 3 on the Kellgren-Lawrence scale, where 4 indicates severe osteoarthritis. A total of 68 individuals were included in the study, all of whom could walk unaided for 25 minutes on a treadmill, maintained a body mass index (BMI) of less than 35 kg/m², and reported a knee pain level of 3 or more on an 11-point scale.
All participants underwent MRI scans and had their walking gaits analyzed in a laboratory setting. They were randomly assigned to either the intervention group or the control group in a 1:1 ratio without knowledge of which group they were in. Over the initial six weeks, participants visited the gait laboratory weekly for training.
The intervention group focused on adjusting their foot progression angle, directing their toes inward or outward by 5 to 10 degrees to relieve knee pressure. In contrast, the control group underwent the same gait training routine, but their natural foot progression angle remained unchanged. Participants from both groups were encouraged to practice the modified walking technique for at least 20 minutes daily until it became habitual.
Throughout the one-year follow-up, participants returned to the laboratory three times to verify their maintenance of the prescribed walking angle. At the conclusion of the study, the intervention group reported a significant reduction in pain compared to the control group. Specifically, the intervention group’s numeric rating scale (NRS) pain score decreased by an average of 2.5 points, whereas the control group only saw a decrease of 1.3 points.
Moreover, MRI results revealed that the intervention group exhibited less degeneration of knee cartilage than their counterparts in the control group. Dr. Kruse expressed excitement over this discovery, emphasizing the promising potential to slow cartilage deterioration through gait retraining. However, he indicated the need for further studies to establish whether the observed slowing of degeneration translates to improved clinical outcomes over time.
image source from：medicalnewstoday
