Biofeedback to reduce knee joint loading during activities of daily living in people with knee osteoarthritis

Abstract

In this thesis, I investigated the acute and chronic effect of gait modification on reducing knee loading, knee pain and improving functional ability for people with knee osteoarthritis (KOA). KOA is a highly prevalent and irreversible joint degeneration disease, the symptoms of which can contribute to reduced quality of life and increased disability burden, especially in older populations. The most typical and crucial symptom of KOA, knee joint pain, can be worsened by increased mechanical loading at the affected compartment of the knee joint during daily life. However, the most common treatment for KOA focuses on reducing knee pain and improving knee joint stiffness through medicine and physiotherapy (such as pain killers and targeted physical exercise), while the underlying biomechanical factors that contribute to the knee degeneration are not addressed.

Abnormal gait patterns can increase the compression force at the specific area on the articular cartilage of the knee joint, thus inducing or increasing the KOA pain. Higher knee loading has been widely reported in KOA populations compared to healthy controls, which is related to the progression of the disease. Therefore, it is important to identify an optimal gait modification that can reduce the loading on the knee joint to relieve knee pain and slow the degeneration of the knee joint in a long run. Due to the configuration of the knee joint, the medial compartment normally sustains higher load than the lateral side, leading to the increased occurrence of injury and degeneration on the medial compartment. Therefore, current gait retraining strategies mainly focus on reducing the magnitude of knee adduction moment (KAM), which represents the ratio of medial knee loading. In this thesis, I investigated how change of gait patterns, mainly foot progression angle (FPA), could be used to reduce KAM during walking and other daily activities in people with KOA.

Date of Award	24 Apr 2024
Original language	English
Awarding Institution	University of Bath
Sponsors	China Scholarship Council
Supervisor	James Bilzon (Supervisor), Polly McGuigan (Supervisor) & Logan Wade (Supervisor)