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.
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e-mail: jwwheel@sandia.gov
e-mail: pshull@stanford.edu
e-mail: besier@stanford.edu
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April 2011
Research Papers
Real-Time Knee Adduction Moment Feedback for Gait Retraining Through Visual and Tactile Displays
Jason W. Wheeler,
e-mail: jwwheel@sandia.gov
Jason W. Wheeler
Sandia National Laboratories
, P.O. Box 5800, Mail Stop 1010, Albuquerque, NM 87185-1010
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Pete B. Shull,
Pete B. Shull
Department of Mechanical Engineering,
e-mail: pshull@stanford.edu
Stanford University
, 424 Panama Mall, Building 560, Stanford, CA 94305-4308
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Thor F. Besier
Thor F. Besier
Department of Orthopaedic Surgery,
e-mail: besier@stanford.edu
Stanford University
, 341 Galvez Street, Stanford, CA 94305-4308
Search for other works by this author on:
Jason W. Wheeler
Sandia National Laboratories
, P.O. Box 5800, Mail Stop 1010, Albuquerque, NM 87185-1010e-mail: jwwheel@sandia.gov
Pete B. Shull
Department of Mechanical Engineering,
Stanford University
, 424 Panama Mall, Building 560, Stanford, CA 94305-4308e-mail: pshull@stanford.edu
Thor F. Besier
Department of Orthopaedic Surgery,
Stanford University
, 341 Galvez Street, Stanford, CA 94305-4308e-mail: besier@stanford.edu
J Biomech Eng. Apr 2011, 133(4): 041007 (5 pages)
Published Online: March 15, 2011
Article history
Received:
June 2, 2010
Revised:
December 22, 2010
Posted:
February 9, 2011
Published:
March 15, 2011
Online:
March 15, 2011
Citation
Wheeler, J. W., Shull, P. B., and Besier, T. F. (March 15, 2011). "Real-Time Knee Adduction Moment Feedback for Gait Retraining Through Visual and Tactile Displays." ASME. J Biomech Eng. April 2011; 133(4): 041007. https://doi.org/10.1115/1.4003621
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