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Tailored Gait Retraining Cuts Pain and Slows Cartilage Loss in Knee Osteoarthritis

The trial’s results suggest a noninvasive, low-cost intervention could replace drugs or delay surgery, prompting validation efforts with AI-driven mobile sensing technologies.

Overview

  • A one-year placebo-controlled trial of 68 adults showed personalized 5°–10° toe-in or toe-out adjustments reduced pain by about 2.5 points on a 10-point scale versus roughly 1 point in the control group.
  • Participants in the intervention group saw a 4% drop in maximum knee loading compared with a more than 3% increase in the sham group, with MRI scans revealing slower medial cartilage degeneration.
  • Researchers used gait lab analysis and computer simulations to identify each participant’s optimal foot angle, excluding those who could not reduce knee loading under any adjustment.
  • Retraining involved six weekly supervised sessions with shin-vibration biofeedback and daily at-home walking practice, achieving adherence within about one degree of the prescribed angle.
  • Investigators plan larger, AI-enhanced trials and smartphone-based sensing studies to broaden inclusion and streamline delivery while addressing limitations such as unmasked trainers, modest enrollment and single-year follow-up.