MADRID, 16 (EUROPA PRESS)
A study led by a team of researchers from NYU Langone Health, the University of Utah, and Stanford University, all in the U.S., examines whether changing the way patients with knee osteoarthritis position their feet while walking could reduce additional loading (stress on the joint during movement) and help treat the condition.
Gait analysis and pain measurements show that subtly adjusting the angle of the foot while walking can reduce knee pain caused by osteoarthritis. This approach may also slow the progression of the condition, an incurable disease in which the cartilage that cushions the joint deteriorates.
For the study, scientists tested this intervention in 68 men and women with mild to moderate knee osteoarthritis, and then used advanced MRI scans to monitor how well it worked.
The results suggest that those trained to angle their feet slightly inward or outward relative to their natural alignment experienced slower cartilage degeneration on the inside of the knee, compared to those encouraged to walk more frequently without changing foot position.
The study, published in The Lancet Rheumatology, found that the earlier patients receive knee replacement, the more likely they are to require additional procedures in the future.
"While our results need to be confirmed in future studies, they raise the possibility that the new noninvasive treatment could help delay surgery," said study co-senior author Dr. Valentina Mazzoli, an assistant professor in the Department of Radiology at NYU Grossman School of Medicine.
The findings also revealed that those who adjusted their foot angle reduced their pain by 2.5 points on a 10-point scale, an effect equivalent to that of over-the-counter pain relievers. In contrast, those who didn't change their gait reduced their pain by just over one point.
"Taken together, our findings suggest that helping patients find the best foot angle to reduce stress on their knees may offer an easy and fairly inexpensive way to address early-stage osteoarthritis," Mazzoli added.
Knee osteoarthritis is a leading cause of disability and is typically treated with pharmaceutical painkillers, physical therapy, and, in the most severe cases, knee replacement surgery. Experts believe that excessive stress can, over time, contribute to this condition.
Previous research has provided little evidence that gait changes can effectively reduce knee pain caused by osteoarthritis. Some previous trials trained all participants to adopt the same foot angle and found no relief, while others did not compare the intervention with a control group or only followed participants for one month.
The new study is the first to show that adapting the angle of each patient's foot to their unique gait pattern can alleviate long-term symptoms of the disease and may slow cartilage deterioration.
This technique could have a significant advantage over pharmaceutical painkillers. These drugs do not address the underlying disease and can cause liver and kidney damage, stomach ulcers, and other unwanted side effects if taken for prolonged periods.
For the study, the research team recorded participants walking on a treadmill in a specialized gait assessment laboratory. A computer program simulated their gait patterns and calculated the maximum load placed on the inner knees. The team then generated computer models of four new foot positions (angled 5 or 10 degrees inward or outward) and estimated which option reduced the load the most.
The patients were randomly divided into two groups. Half received six sessions of training to walk at their ideal angle, while the other half received instructions to continue walking naturally. Pain scores and MRIs were obtained at baseline and one year after the intervention.
The study results showed that those who adjusted their gait pattern reduced the maximum load on their knees by 4 percent, while those who maintained their normal gait pattern increased their load by more than 3 percent.
"These results highlight the importance of personalizing treatment rather than adopting a one-size-fits-all approach to osteoarthritis. While this strategy may seem complex, recent advances in artificial intelligence (AI) in detecting the movement of different body parts could make it easier and faster than ever before," says Mazzoli.
While the authors relied on a specialized laboratory for the new study, artificial intelligence software is now available that estimates joint loading using smartphone videos and can allow physicians to perform gait analysis in the clinic.
The researchers now plan to test whether these tools can identify the most effective walking method for patients with osteoarthritis. They also plan to expand their study to include people with obesity.
